Hildebrandt W, Ottenbacher A, Schuster M, Swenson E R, Bärtsch P
Department of Sports Medicine, Heidelberg University, 69115 Heidelberg, Germany.
J Appl Physiol (1985). 2000 Feb;88(2):599-610. doi: 10.1152/jappl.2000.88.2.599.
We studied the contributions of hypoxemia, hypocapnia, and hyperpnea to the acute hypoxic diuretic response (HDR) in humans and evaluated the role of peripheral O(2) chemosensitivity and renal hormones in HDR. Thirteen healthy male subjects (age 19-38 yr) were examined after sodium equilibration (intake: 120 mmol/day) during 90 min of normoxia (NO), poikilocapnic hypoxia (PH), and isocapnic hypoxia (IH) (days 1-3, random order, double blind), as well as normoxic voluntary hyperpnea (HP; day 4), matching ventilation during IH. O(2) saturation during PH and IH was kept equal to a mean level measured between 30 and 90 min of breathing 12% O(2) in a pretest. Urine flow during PH and IH (1.81 +/- 0.92 and 1.94 +/- 1.03 ml/min, respectively) but not during HP (1.64 +/- 0.96 ml/min) significantly exceeded that during NO (control, 1.38 +/- 0.71 ml/min). Urine flow increases vs. each test day's baseline were significant with PH, IH, and HP. Differences in glomerular filtration rate, fractional sodium clearance, urodilatin, systemic blood pressure, or leg venous compliance were excluded as factors of HDR. However, slight increases in plasma and urinary endothelin-1 and epinephrine with PH and IH could play a role. In conclusion, the early HDR in humans is mainly due to hypoxia and hypocapnia. It occurs without natriuresis and is unrelated to O(2) chemosensitivity (hypoxic ventilatory response).
我们研究了低氧血症、低碳酸血症和呼吸急促对人类急性低氧利尿反应（HDR）的影响，并评估了外周氧化学感受器敏感性和肾素在HDR中的作用。13名健康男性受试者（年龄19 - 38岁）在钠平衡（摄入量：120 mmol/天）后，于常氧（NO）、异碳酸低氧（PH）和等碳酸低氧（IH）（第1 - 3天，随机顺序，双盲）的90分钟期间接受检查，以及常氧下的自主呼吸急促（HP；第4天），使HP期间的通气量与IH期间相匹配。PH和IH期间的氧饱和度保持在预试验中呼吸12%氧气30至90分钟期间测得的平均水平。PH和IH期间的尿流率（分别为1.81±0.92和1.94±1.03 ml/分钟）显著超过NO期间（对照，1.38±0.71 ml/分钟），但HP期间（1.64±0.96 ml/分钟）未超过。与各试验日基线相比，PH、IH和HP时尿流率均显著增加。肾小球滤过率、钠排泄分数、尿舒张素、全身血压或腿部静脉顺应性的差异被排除为HDR的影响因素。然而，PH和IH时血浆和尿中内皮素 - 1及肾上腺素的轻微升高可能起作用。总之，人类早期的HDR主要归因于低氧和低碳酸血症。它在无钠利尿的情况下发生，且与氧化学感受器敏感性（低氧通气反应）无关。
