Kusaka Ikuyo, Saito Takako, Nakamura Tomoatsu, Nagasaka Shoichiro, Ishibashi Shun, Ishikawa San-e
Division of Endocrinology and Metabolism, Department of Medicine, Jichi Medical School, Tochigi, Japan.
Nephron. 2002 May;91(1):167-9. doi: 10.1159/000057622.
We studied the changes in plasma arginine vasopressin (AVP) and urinary excretion of aquaporin-2 (UAQP-2) water channel in 3 patients with diabetic ketoacidosis. They had marked hyperglycemia of 27.9 +/- 2.8 mmol/l (mean +/- SEM), and elevated hemoglobin A1c of 8.8 +/- 1.4%. Circulatory blood volume was decreased by approximately 25%, which was determined by the changes in hematocrit. Plasma AVP levels were elevated to 10.3 +/- 3.0 pmol/l and UAQP-2, 578 +/- 200 fmol/mg creatinine (normal, 153 +/- 28) at the hospitalization. When hyperglycemia was improved by the intravenous infusion of a small dose of insulin plus fluid administration, both plasma AVP and UAQP-2 promptly decreased to 1.2 +/- 0.2 pmol/l and 252 +/- 29 fmol/mg creatinine on day 7, respectively. These alterations were concomitant with the recovery of circulatory blood volume. In the present study, UAQP-2, in addition to plasma AVP, indicates circulatory blood volume depletion, and the changes in UAQP-2 estimates the AVP-dependent recovery of circulatory blood volume during the therapeutic period in the patients with diabetic ketoacidosis.
我们研究了3例糖尿病酮症酸中毒患者血浆精氨酸加压素（AVP）和水通道蛋白2（UAQP-2）水通道的尿排泄变化。他们的血糖显著升高，为27.9±2.8 mmol/L（平均值±标准误），糖化血红蛋白升高至8.8±1.4%。循环血容量减少了约25%，这是由血细胞比容的变化确定的。住院时血浆AVP水平升高至10.3±3.0 pmol/L，UAQP-2为578±200 fmol/mg肌酐（正常为153±28）。当通过静脉输注小剂量胰岛素加补液使高血糖得到改善时，血浆AVP和UAQP-2在第7天分别迅速降至1.2±0.2 pmol/L和252±29 fmol/mg肌酐。这些变化与循环血容量的恢复同时发生。在本研究中，除血浆AVP外，UAQP-2也表明循环血容量减少，并且UAQP-2的变化可评估糖尿病酮症酸中毒患者治疗期间依赖AVP的循环血容量恢复情况。
