Shimizu H, Tanaka Y, Nakamura K, Uehara Y, Shimomura Y
First Department of Internal Medicine, Gunma University School of Medicine, Maebashi, Japan.
J Med. 1991;22(4-5):299-305.
A 42-year-old woman was admitted to our hospital because of polydipsia and polyuria. On admission, the daily urine volume was about 6 to 8 L/day, and the plasma arginine vasopressin (AVP) level was undetectable. To determine an involvement of atrial natriuretic peptide (ANP) in maintaining plasma volume homeostasis in the patient with diabetes insipidus (DI), changes of plasma ANP levels were measured during the daytime and after 2.5% hypertonic saline followed by intravenous administration of Pitressin. The plasma ANP level was maintained within a normal range during the day. An intravenous infusion of 2.5% hypertonic saline increased plasma ANP levels, while it failed to increase urine osmolality. The addition of an intravenous bolus of Pitressin (10 U) increased urine osmolality with a decrease of urine volume. Plasma ANP levels showed only a transient decrease at 15 min after Pitressin injection. A daily supplement of 1-desamino-8-D-arginine vasopressin (DDAVP) slightly decreased plasma ANP levels. The present study suggests that an increase in plasma AVP level may not have a direct stimulatory action on ANP secretion in patients with DI.
一名42岁女性因多饮、多尿入院。入院时，每日尿量约为6至8升/天，血浆精氨酸加压素（AVP）水平检测不到。为了确定心房利钠肽（ANP）在维持尿崩症（DI）患者血浆容量稳态中的作用，在白天以及静脉注射垂体后叶素后给予2.5%高渗盐水，测量血浆ANP水平的变化。白天血浆ANP水平维持在正常范围内。静脉输注2.5%高渗盐水可增加血浆ANP水平，但未能增加尿渗透压。静脉推注垂体后叶素（10 U）可增加尿渗透压并减少尿量。注射垂体后叶素15分钟后，血浆ANP水平仅出现短暂下降。每日补充1-去氨基-8-D-精氨酸加压素（DDAVP）可使血浆ANP水平略有下降。本研究表明，血浆AVP水平升高可能对DI患者的ANP分泌没有直接刺激作用。
