Valverde J, Martínez-Ródenas F, Pereira J A, Carulla X, Jiménez W, Gubern J M, Sitges-Serra A
Department of Surgery, Hospital Universitari del Mar, Autonomous University of Barcelona, Spain.
Ann Surg. 1992 Nov;216(5):554-9. doi: 10.1097/00000658-199211000-00005.
Previous studies have shown that common bile duct ligation in the rabbit is followed by a reduction of the extracellular water compartment. To further elucidate the mechanisms leading to volume depletion in this model, water and sodium balances and changes in plasma concentrations of atrial natriuretic peptide (ANP), vasopressin (ADH), plasma renin activity (PRA) and aldosterone (Ald) were investigated during the first 4 days after common bile duct ligation (group OJ,) or sham operation (group SO). Water and chow intakes were lower in group OJ (148 +/- 30 versus 226 +/- 40 mL/4 days; p = 0.004 and 12 +/- 9 versus 171 +/- 40 g/4 days; p = 0.0001). There were no differences in urine output. Sodium urinary losses were marginally higher in group OJ (12.4 +/- 7 versus 6.7 +/- 5 mEq/4 days; p = 0.06). Water balance was lower in group OJ (-50 +/- 56 versus 101 +/- 71 mL/4 days; p = 0.0001). At 24 hours, plasma ANP (41 +/- 7 versus 10.7 +/- 1 fmol/mL, p = 0.0001), ADH (21.8 +/- 7 versus 12.3 +/- 6 pg/mL, p = 0.008) and Ald (14.5 +/- 5 versus 3.7 +/- 3 ng/dL, p = 0.001) were higher in group OJ. These alterations persisted 72 hours after bile duct ligation, when a concomitant increase in PRA (10.7 +/- 5 versus 3 +/- 1.6 ng/dL, p = 0.006) was also observed. A group of pair-fed pair-watered sham-operated controls (group SO2, n = 13) showed a metabolic profile similar to group OJ but a low ANP concentration. Multiple venous sampling in five rabbits 24 hours after bile duct ligation showed the highest plasma levels of ANP in the aorta and infrarenal vena cava. These results suggest that common bile duct ligation in the rabbit is followed by marked hypodipsia and hypophagia, possibly mediated by ANP, leading to isotonic volume depletion and secondary activation of the water and sodium retaining hormones.
以往的研究表明,兔胆总管结扎后细胞外液腔会减少。为了进一步阐明该模型中导致容量耗竭的机制,在胆总管结扎后第1天至第4天(OJ组)或假手术(SO组)期间,研究了水和钠平衡以及血浆心房利钠肽(ANP)、血管加压素(ADH)、血浆肾素活性(PRA)和醛固酮(Ald)浓度的变化。OJ组的水摄入量和食物摄入量较低(分别为148±30 vs 226±40 mL/4天;p = 0.004和12±9 vs 171±40 g/4天;p = 0.0001)。尿量无差异。OJ组的尿钠丢失略高(12.4±7 vs 6.7±5 mEq/4天;p = 0.06)。OJ组的水平衡较低(-50±56 vs 101±71 mL/4天;p = 0.0001)。在24小时时,OJ组的血浆ANP(41±7 vs 10.7±1 fmol/mL,p = 0.0001)、ADH(21.8±7 vs 12.3±6 pg/mL,p = 0.008)和Ald(14.5±5 vs 3.7±3 ng/dL,p = 0.001)较高。这些改变在胆管结扎后72小时持续存在,此时还观察到PRA同时升高(10.7±5 vs 3±1.6 ng/dL,p = 0.006)。一组配对喂食和配对饮水的假手术对照组(SO2组,n = 13)显示出与OJ组相似的代谢特征,但ANP浓度较低。在胆管结扎后24小时对5只兔子进行多次静脉采样,结果显示主动脉和肾下腔静脉中的血浆ANP水平最高。这些结果表明,兔胆总管结扎后会出现明显的低渴感和食欲减退,可能由ANP介导,导致等渗性容量耗竭以及保水和保钠激素的继发性激活。