ROLE OF VASOPRESSIN IN ABNORMAL WATER-EXCRETION IN CIRRHOTIC-PATIENTS
ROLE OF VASOPRESSIN IN ABNORMAL WATER-EXCRETION IN CIRRHOTIC-PATIENTS
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DOI：
10.7326/0003-4819-96-4-413
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发表时间：
1982-01-01
影响因子：
39.2
通讯作者：
SCHRIER, RW
中科院分区：
文献类型：
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作者：
BICHET, D;SZATALOWICZ, V;SCHRIER, RW
12 名患有腹水的稳定肝硬化患者接受了 20 ml/kg H2O 负荷。 7 名患者的 H2O 排泄异常（5 小时内 H2O 负荷的 27.3% .+/-. 5.4%），最小尿渗透压为 262 mosmol/kg H2O。 5 名患者在 5 小时内排泄 82.6%，最小尿渗透压为 65 mosmol/kg H2O。 H2O 负荷后，第 1 组的平均血浆精氨酸加压素值 (1.34 .+-. 0.36 pg/ml) 显着高于第 2 组（检测不到）。较低的血浆白蛋白（2.5 vs. 3.3 g/dl，P < 0.02）、较高的脉率（96 vs. 72，P < 0.001）、较高的血浆肾素活性（7.8 vs. 1.5 ng/ml/h，P < 0.005）、较高的血浆醛固酮（66 vs. 21）表明第 1 组患者的有效血容量低于第 2 组患者。 ng/dl，P < 0.05），尿钠排泄量较低（2.7 vs. 14.2 meq Na/5 h，P < 0.005）。有效血容量减少继发的加压素非渗透刺激是肝硬化 H2O 排泄异常的重要因素。
Twelve stable cirrhotic patients with ascites received a 20 ml/kg H2O load. Seven patients had abnormal H2O excretion (27.3% .+-. 5.4% of the H2O load in 5 h) and a minimal urine osmolality of 262 mosmol/kg H2O. Five patients excreted 82.6% in 5 h and had a minimal urine osmolality of 65 mosmol/kg H2O. Mean plasma arginine vasopressin values after H2O load were significantly higher in Group 1 (1.34 .+-. 0.36 pg/ml) than in Group 2 (undetectable). An effective blood volume lower in Group 1 than Group 2 patients was suggested by a lower plasma albumin (2.5 vs. 3.3 g/dl, P < 0.02), a higher pulse rate (96 vs. 72, P < 0.001) a higher plasma renin activity (7.8 vs. 1.5 ng/ml per h, P < 0.005), a higher plasma aldosterone (66 vs. 21 ng/dl, P < 0.05), and a lower urinary Na excretion (2.7 vs. 14.2 meq Na/5 h, P < 0.005). Nonosmotic stimulation of vasopressin secondary to a decrease in effective blood volume is an important factor in the abnormal H2O excretion in cirrhosis.