RADIOIMMUNOASSAY OF PLASMA ARGININE VASOPRESSIN IN HYPONATREMIC PATIENTS WITH CONGESTIVE HEART-FAILURE
RADIOIMMUNOASSAY OF PLASMA ARGININE VASOPRESSIN IN HYPONATREMIC PATIENTS WITH CONGESTIVE HEART-FAILURE
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DOI：
10.1056/nejm198107303050506
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发表时间：
1981-01-01
影响因子：
158.5
通讯作者：
SCHRIER, RW
中科院分区：
文献类型：
--
作者：
SZATALOWICZ, VL;ARNOLD, PE;SCHRIER, RW
低钠血症常发生于中度液体摄入（1-3 l/天）的充血性心力衰竭患者。是否持续释放精氨酸加压素（AVP，哺乳动物抗利尿激素[ADH]）或肾内因素造成这种受损的水分排泄尚不清楚。本文应用放射免疫法测定了37例充血性心力衰竭伴低钠血症患者的精氨酸加压素（AVP）。37名患者中有30名可检测到AVP水平; 30名患者中有11名从未接受过利尿剂。30例AVP阳性患者的低钠血症和低渗血症程度较7例AVP阴性患者严重，肾功能损害程度较重。虽然这些结果暗示血管加压素的不适当释放在充血性心力衰竭低钠血症的机制中，但它们并不排除肾内因素的贡献。
HYPONATREMIA occurs frequently in patients with congestive heart failure who have moderate fluid intakes (1-3 l/day). Whether persistent release of arginine vasopressin (AVP the mammalian antidiuretic hormone [ADH]) or intrarenal factors account for this impaired water excretion is unclear. A sensitive radioimmunoassay technique was used to measure AVP in 37 patients with congestive heart failure and associated hyponatremia. AVP levels were detectable in 30 of the 37 patients; 11 of the 30 had never received diuretics. The degree of hyponatremia and hypoosmolality was more severe and renal function more impaired in the 30 patients with detectable AVP levels than in the 7 patients with undetectable AVP levels. Although the results implicate inappropriate release of vasopressin in the mechanism of hyponatremia in congestive heart failure, they do not exclude a contribution by intrarenal factors.