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口服避孕药对体液调节的影响。

Effects of oral contraceptives on body fluid regulation.

作者信息

Stachenfeld N S, Silva C, Keefe D L, Kokoszka C A, Nadel E R

机构信息

The John B. Pierce Laboratory, Department of Epidemiology and Public Health, and Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, Connecticut 06519, USA.

出版信息

J Appl Physiol (1985). 1999 Sep;87(3):1016-25. doi: 10.1152/jappl.1999.87.3.1016.

Abstract

To test the hypothesis that estrogen reduces the operating point for osmoregulation of arginine vasopressin (AVP), thirst, and body water balance, we studied nine women (25 +/- 1 yr) during 150 min of dehydrating exercise followed by 180 min of ad libitum rehydration. Subjects were tested six different times, during the early-follicular (twice) and midluteal (twice) menstrual phases and after 4 wk of combined [estradiol-norethindrone (progestin), OC E + P] and 4 wk of norethindrone (progestin only, OC P) oral contraceptive administration, in a randomized crossover design. Basal plasma osmolality (P(osm)) was lower in the luteal phase (281 +/- 1 mosmol/kgH(2)O, combined means, P < 0.05), OC E + P (281 +/- 1 mosmol/kgH(2)O, P < 0.05), and OC P (282 +/- 1 mosmol/kgH(2)O, P < 0. 05) than in the follicular phase (286 +/- 1 mosmol/kgH(2)O, combined means). High plasma estradiol concentration lowered the P(osm) threshold for AVP release during the luteal phase and during OC E + P [x-intercepts, 282 +/- 2, 278 +/- 2, 276 +/- 2, and 280 +/- 2 mosmol/kgH(2)O, for follicular, luteal (combined means), OC E + P, and OC P, respectively; P < 0.05, luteal phase and OC E + P vs. follicular phase] during exercise dehydration, and 17beta-estradiol administration lowered the P(osm) threshold for thirst stimulation [x-intercepts, 280 +/- 2, 279 +/- 2, 276 +/- 2, and 280 +/- 2 mosmol/kgH(2)O for follicular, luteal, OC E + P, and OC P, respectively; P < 0.05, OC E + P vs. follicular phase], without affecting body fluid balance. When plasma 17beta-estradiol concentration was high, P(osm) was low throughout rest, exercise, and rehydration, but plasma arginine vasopressin concentration, thirst, and body fluid retention were unchanged, indicating a lowering of the osmotic operating point for body fluid regulation.

摘要

为了验证雌激素会降低精氨酸加压素(AVP)的渗透调节作用点、口渴感及身体水平衡这一假设,我们对9名女性(25±1岁)进行了研究。她们先进行150分钟的脱水运动,随后进行180分钟的随意补液。研究采用随机交叉设计,在卵泡期早期(两次)、黄体中期(两次)以及口服复方[雌二醇 - 炔诺酮(孕激素),复方口服避孕药E + P] 4周和炔诺酮(仅孕激素,口服避孕药P)4周后,对受试者进行了6次不同测试。黄体期(联合均值为281±1 mOsmol/kgH₂O,P < 0.05)、复方口服避孕药E + P组(281±1 mOsmol/kgH₂O,P < 0.05)和口服避孕药P组(282±1 mOsmol/kgH₂O,P < 0.05)的基础血浆渗透压(P(osm))低于卵泡期(联合均值为286±1 mOsmol/kgH₂O)。在运动性脱水期间,高血浆雌二醇浓度降低了黄体期和复方口服避孕药E + P组中AVP释放的P(osm)阈值[卵泡期、黄体期(联合均值)、复方口服避孕药E + P组和口服避孕药P组的x轴截距分别为282±2、278±2、276±2和280±2 mOsmol/kgH₂O;P < 0.05,黄体期和复方口服避孕药E + P组与卵泡期相比],并且给予17β - 雌二醇降低了口渴刺激的P(osm)阈值[卵泡期、黄体期、复方口服避孕药E + P组和口服避孕药P组的x轴截距分别为280±2、279±2、276±2和280±2 mOsmol/kgH₂O;P < 0.05,复方口服避孕药E + P组与卵泡期相比],且不影响体液平衡。当血浆17β - 雌二醇浓度较高时,在整个休息、运动和补液过程中P(osm)较低,但血浆精氨酸加压素浓度、口渴感和体液潴留均未改变,表明体液调节的渗透作用点降低。

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