Harvey J N, Nagi D K, Baylis P H, Wilkinson R, Belchetz P E
Department of Endocrinology, General Infirmary, Leeds.
Clin Endocrinol (Oxf). 1991 Jul;35(1):29-33. doi: 10.1111/j.1365-2265.1991.tb03492.x.
To assess the effect of untreated thyrotoxicosis on osmoregulated thirst sensation and AVP secretion.
Measurements were made at 30-minute intervals while untreated thyrotoxic patients were given sodium chloride 855 mmol/l intravenously for 2 hours followed by water drinking ad libitum for 2 hours. The protocol was repeated when the patients were euthyroid.
Eight newly diagnosed thyrotoxic patients were studied.
Thirst sensation (visual analogue scale), plasma osmolality, AVP and plasma renin activity were measured.
Prior to osmotic stimulation and after plasma osmolality had been returned to normal by drinking water, thirst sensation was increased in the thyrotoxic state. Plasma AVP showed an exaggerated response to hypertonic saline in the patients when they were thyrotoxic. Increasing plasma osmolality produced a linear increase in thirst sensation and log linear increase in plasma AVP. However, in the thyrotoxic state both these relations were altered. The apparent osmolar thresholds for onset of thirst sensation and AVP release were similar (281 and 280 mosm/kg respectively) and were reduced similarly in the thyrotoxic state (269 and 274 mosm/kg respectively).
The osmostat mechanisms which regulate thirst sensation and AVP release are reset in the thyrotoxic state. The responses of thirst sensation and of plasma AVP to increasing plasma osmolality are altered similarly, suggesting that thyrotoxicosis affects both homeostatic functions by a common mechanism.
评估未经治疗的甲状腺毒症对渗透压调节的口渴感觉及抗利尿激素（AVP）分泌的影响。
对未经治疗的甲状腺毒症患者静脉输注855 mmol/l氯化钠2小时，随后随意饮水2小时，期间每隔30分钟进行测量。患者甲状腺功能正常时重复该方案。
研究了8例新诊断的甲状腺毒症患者。
测量口渴感觉（视觉模拟评分）、血浆渗透压、AVP及血浆肾素活性。
在渗透压刺激前及饮水使血浆渗透压恢复正常后，甲状腺毒症状态下口渴感觉增强。甲状腺毒症患者血浆AVP对高渗盐水的反应增强。血浆渗透压升高使口渴感觉呈线性增加，血浆AVP呈对数线性增加。然而，在甲状腺毒症状态下，这两种关系均发生改变。口渴感觉和AVP释放开始时的表观渗透压阈值相似（分别为281和280 mosm/kg），在甲状腺毒症状态下均类似降低（分别为269和274 mosm/kg）。
调节口渴感觉和AVP释放的渗透压调节机制在甲状腺毒症状态下发生重置。口渴感觉和血浆AVP对血浆渗透压升高的反应类似改变，提示甲状腺毒症通过共同机制影响这两种稳态功能。
