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正常受试者在急性严格卧床休息期间用于揭示液体消耗的体液容量分区和生化测量。

Fluid volume compartments and biochemical measurements for disclosing fluid depletion during acute and rigorous bed rest in normal subjects.

作者信息

Zorbas Yan G, Yarullin Vladimir L, Denogratov Sergei D, Luzhkov Yevgeni S, Kuznetsov Nikolai A

机构信息

Hypokinetic Physiology Laboratory, Athens, Greece.

出版信息

Int Urol Nephrol. 2002;34(4):467-76. doi: 10.1023/a:1025698316019.

Abstract

Rigorous bed rest (RBR) induces fluid depletion, however, little is known about the mechanisms of development of fluid depletion during acute bed rest (ABR). Measuring fluid retention and body hydration parameters, the aim of this study was to establish whether ABR than RBR could depress significantly more fluid retention contributing to greater fluid depletion development. Studies were conducted during pre bed rest (BR) period of three days and during seven days period of ABR and RBR. Thirty normal male individuals aged, 24.2 +/- 5.0 years chosen as subjects. They were divided into three groups: unrestricted ambulatory control subjects (UACS), acute bed rested subjects (ABRS) and rigorous bed rested subjects (RBRS). Acute bed rested subjects confined abruptly to RBR, while they did not have any prior knowledge of the exact date and time when they would be asked to stay in bed. Rigorous bed rested subjects submitted to RBR on a predetermined date and time known to them right from the start of the study. Unrestricted ambulatory control subjects were not confined to any type of bed rest. Fluid loss, urinary and plasma sodium (Na+) and potassium (K+), urinary osmolality and plasma osmolality, whole blood hematocrit (Hct), whole blood hemoglobin (Hb), and total plasma protein increased significantly (p < 0.05) with time, while fluid retention, extracellular volume (ECV), plasma volume (PV), red cell volume (RCV), blood volume (BV), interstitial volume (IV) and fluid intakes reduced significantly (p < 0.05) with time in ABRS and RBRS compared with their pre-BR values and the control values (UACS). However, the measured parameters changed significantly (p < 0.05) more with time in ABRS than RBRS. Fluid rention, fluid loss, fluid intake, urinary and plasma Na+ and K+, Hct, Hb, plasma protein, urinary and plasma osmolality, ECV, PV, RCV, BV and IV did not change in UACS compared with their pre-BR values. It was concluded that significant increase of urinary and plasma osmolality, whole blood Hct and Hb, total plasma protein, plasma Na+ and K+, and significant decrease of ECV, PV, RCV, BV, and IV may demonstrate fluid depleteion, while a higher increase of fluid loss in spite of fluid depletion may show decreased fluid retention. Dissociation between fluid losses and fluid depletion may suggest the presence of impair fluid retention as a mechanism of development of fluid depletion.

摘要

严格卧床休息(RBR)会导致体液流失,然而,对于急性卧床休息(ABR)期间体液流失的发生机制知之甚少。通过测量体液潴留和身体水合参数,本研究的目的是确定ABR是否比RBR能更显著地抑制体液潴留,从而导致更多的体液流失。研究在三天的卧床休息前(BR)期以及ABR和RBR的七天期内进行。选择30名年龄为24.2±5.0岁的正常男性个体作为研究对象。他们被分为三组:无限制活动对照组(UACS)、急性卧床休息组(ABRS)和严格卧床休息组(RBRS)。急性卧床休息组突然被限制进行RBR,而他们事先并不知道被要求卧床的确切日期和时间。严格卧床休息组从研究开始就按照预定的日期和时间进行RBR。无限制活动对照组不进行任何形式的卧床休息。与卧床休息前(BR)值和对照组(UACS)相比,ABRS和RBRS组的体液流失、尿钠和血浆钠(Na+)及钾(K+)、尿渗透压和血浆渗透压、全血细胞比容(Hct)、全血血红蛋白(Hb)以及总血浆蛋白随时间显著增加(p<0.05),而体液潴留、细胞外液量(ECV)、血浆量(PV)、红细胞量(RCV)、血量(BV)、间质液量(IV)和液体摄入量随时间显著减少(p<0.05)。然而,与RBRS组相比,ABRS组中测量参数随时间的变化更为显著(p<0.05)。与卧床休息前(BR)值相比,UACS组的体液潴留、体液流失、液体摄入量、尿钠和血浆钠及钾、Hct、Hb、血浆蛋白、尿渗透压和血浆渗透压、ECV、PV、RCV、BV和IV均无变化。研究得出结论,尿渗透压和血浆渗透压、全血Hct和Hb、总血浆蛋白、血浆Na+和K+的显著增加,以及ECV、PV、RCV、BV和IV的显著减少可能表明存在体液流失,而尽管存在体液流失但更高的体液流失增加可能表明体液潴留减少。体液流失与体液流失之间的分离可能提示存在受损的体液潴留,这是体液流失发生的一种机制。

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