Del Bo A, Marabini M, Morganti A, Zanchetti A
Istituto di Clinica Medica Generale e Terapia Medica, Università di Milano, Milan, Italy.
Clin Auton Res. 1991 Jun;1(2):109-14. doi: 10.1007/BF01826205.
Vasopressin plasma concentrations have been measured in two groups of subjects, 13 moderate essential hypertensive patients without target organ damage and eight control normotensive subjects, before and after the assumption of the upright position, and intravenous infusions of hypotonic saline (0.45% NaCl, 0.25 ml kg-1 min-1 for 1 h) and hypertonic saline (100 mmol NaCl in 50 ml). Plasma vasopressin in recumbent baseline conditions was not significantly different in the two groups. Upright posture and hypertonic challenge augmented, while hypotonic saline reduced plasma vasopressin levels, which were not significantly different between the two groups. Plasma renin activity increased in the upright position, was reduced by administration of hypotonic saline and unaffected by hypertonic saline, with no differences between the hypertensives and normotensives. After hypertonic saline, urinary flow rate and urinary sodium excretion in the hypertensive group increased to values significantly (p less than 0.05) higher than in normotensive subjects. In conclusion our study excludes significant alteration of vasopressin regulation in moderate uncomplicated hypertension. In hypertensives although the response of vasopressin to an osmotic load is preserved, the data suggest that the renal handling of the osmotic load may be altered.
在两组受试者中测量了血管加压素的血浆浓度，一组为13名无靶器官损害的中度原发性高血压患者，另一组为8名血压正常的对照受试者。在采取直立姿势前后，以及静脉输注低渗盐水（0.45%氯化钠，0.25 ml·kg-1·min-1，持续1小时）和高渗盐水（50 ml中含100 mmol氯化钠）后进行测量。两组在卧位基线条件下的血浆血管加压素无显著差异。直立姿势和高渗刺激使血浆血管加压素水平升高，而低渗盐水使其降低，两组之间无显著差异。血浆肾素活性在直立位时升高，低渗盐水给药使其降低，高渗盐水对其无影响，高血压患者和血压正常者之间无差异。给予高渗盐水后，高血压组的尿流率和尿钠排泄量增加至显著高于血压正常受试者的值（p<0.05）。总之，我们的研究排除了中度单纯性高血压患者血管加压素调节的显著改变。在高血压患者中，尽管血管加压素对渗透负荷的反应得以保留，但数据表明对渗透负荷的肾脏处理可能发生改变。
