Solis-Herruzo J A, Gonzalez-Gamarra A, Castellano G, Muñoz-Yagüe M T
Department of Medicine, Hospital Universitario Doce de Octubre, School of Medicine, Universidad Complutense, Madrid, Spain.
Hepatology. 1992 Oct;16(4):974-9. doi: 10.1002/hep.1840160420.
Metabolic clearance rate and half-time of arginine vasopressin were measured in 43 cirrhotic patients and 10 control subjects. Synthetic arginine vasopressin was infused intravenously at a rate of 500 pg/min/kg of body weight for 75 min. The metabolic clearance rate was significantly reduced, and the half-time of arginine vasopressin after stopping the infusion was significantly increased in patients with cirrhosis, particularly in those with ascites and in those with moderate or severe liver dysfunction. Changes in metabolic clearance rate and half-time of arginine vasopressin correlated with the score of the liver dysfunction, prothrombin activity and levels of serum albumin and bilirubin but not with parameters of kidney function (serum creatinine levels and clearance of creatinine). We conclude that reduced metabolic clearance rate and prolonged half-time of vasopressin in plasma are frequent findings in cirrhotic patients with poor liver function. This impaired catabolism of antidiuretic hormone may contribute to maintaining elevated plasma levels of this hormone in these patients and may be an additional factor leading to fluid retention and to dilutional hyponatremia.
对43例肝硬化患者和10名对照受试者测定了精氨酸加压素的代谢清除率和半衰期。以500 pg/分钟/千克体重的速率静脉输注合成精氨酸加压素75分钟。肝硬化患者的代谢清除率显著降低，停止输注后精氨酸加压素的半衰期显著延长，尤其是有腹水的患者以及有中度或重度肝功能不全的患者。精氨酸加压素代谢清除率和半衰期的变化与肝功能评分、凝血酶原活性以及血清白蛋白和胆红素水平相关，但与肾功能参数（血清肌酐水平和肌酐清除率）无关。我们得出结论，血浆中加压素代谢清除率降低和半衰期延长在肝功能差的肝硬化患者中很常见。抗利尿激素这种分解代谢受损可能有助于维持这些患者血浆中该激素的高水平，并且可能是导致液体潴留和稀释性低钠血症的另一个因素。
