Drummer C, Heer M, Baisch F, Blomqvist C G, Lang R E, Maass H, Gerzer R
Medizinische Klinik Innenstadt, University of Munich, Germany.
Acta Physiol Scand Suppl. 1992;604:101-11.
In the present study the response to acute saline loading was investigated. During a 24-day study period six male subjects followed a standardized diet including a daily intake of 40 ml water and 125 mg NaCl per kg body weight. Before, during, and after a ten-day period of 6 degrees head down tilt (HDT) each volunteer received an intravenous 0.9% saline infusion of 22 ml/kg body weight over 20 minutes. HDT produced significant losses in body weight and in blood volume, but the responses to saline loading were similar during all phases of the study. Plasma levels of atrial natriuretic peptide (ANP) did not increase, while plasma levels of cyclic GMP increased by about 40% 90 minutes after each infusion. Urine flow nearly doubled during second hour post-infusion. Sodium excretion showed a 3-fold increase and remained elevated during the third hour, while potassium excretion was significantly reduced. Urinary excretion of cyclic GMP reached a peak during the second hour post-infusion. At the end of these short-term periods the cumulative water- and sodium-balance data disclosed that only about 20% of the infused water and less than 15% of the infused sodium was excreted during each experiment. In addition to the short-term renal response, urine flow and sodium excretion remained significantly elevated for more than 48 hours after each saline load. The long-term renal response was paralleled by an increased excretion of urinary cyclic GMP. HDT produced significant changes in body fluid distribution, but only minor changes in the regulatory responses to an acute saline load. We conclude from these data that the excretion of an acute isotonic saline load requires several days and that the renal response appears to be independent of the secretion of ANP from the heart.
在本研究中,对急性盐水负荷的反应进行了调查。在为期24天的研究期间,6名男性受试者遵循标准化饮食,包括每天每公斤体重摄入40毫升水和125毫克氯化钠。在为期十天的6度头低位倾斜(HDT)之前、期间和之后,每位志愿者在20分钟内接受了每公斤体重22毫升的静脉注射0.9%盐水。HDT导致体重和血容量显著下降,但在研究的所有阶段对盐水负荷的反应相似。心房利钠肽(ANP)的血浆水平没有增加,而每次输注后90分钟,环磷酸鸟苷(cGMP)的血浆水平增加了约40%。输注后第二小时尿量几乎增加了一倍。钠排泄增加了3倍,并在第三小时保持升高,而钾排泄显著减少。环磷酸鸟苷的尿排泄在输注后第二小时达到峰值。在这些短期阶段结束时,累积的水和钠平衡数据显示,在每个实验中,仅约20%的输注水和不到15%的输注钠被排泄。除了短期肾脏反应外,每次盐水负荷后,尿量和钠排泄在48小时以上仍显著升高。长期肾脏反应伴随着尿中环磷酸鸟苷排泄的增加。HDT导致体液分布发生显著变化,但对急性盐水负荷的调节反应仅发生轻微变化。我们从这些数据中得出结论,急性等渗盐水负荷的排泄需要数天时间,并且肾脏反应似乎独立于心脏ANP的分泌。