Department of Endocrinology, Children's Hospital and Research Center Oakland, CA 94609, USA.
Endocrinol Metab Clin North Am. 2009 Dec;38(4):663-72. doi: 10.1016/j.ecl.2009.08.002.
Fluid homeostasis requires adequate water intake, regulated by an intact thirst mechanism and appropriate free water excretion by the kidneys, mediated by appropriate secretion of arginine vasopressin (AVP, also known as antidiuretic hormone). AVP exerts its antidiuretic action by binding to the X chromosome-encoded V2 vasopressin receptor (V2R), a G protein-coupled receptor on the basolateral membrane of renal collecting duct epithelial cells. After V2R activation, increased intracellular cyclic adenosine monophosphate mediates shuttling of the water channel aquaporin 2 to the apical membrane of collecting duct cells, resulting in increased water permeability and antidiuresis. Clinical disorders of water balance are common, and abnormalities in many steps involving AVP secretion and responsiveness have been described. This article focuses on the principal disorders of water balance, diabetes insipidus, and the syndrome of inappropriate antidiuretic hormone secretion.
体液平衡需要充足的水分摄入，这由完整的口渴机制和肾脏适当的自由水排泄来调节，由适当分泌的精氨酸加压素（AVP，也称为抗利尿激素）介导。AVP 通过与 X 染色体编码的 V2 加压素受体（V2R）结合发挥其抗利尿作用，V2R 是肾脏集合管上皮细胞基底外侧膜上的 G 蛋白偶联受体。V2R 激活后，细胞内环磷酸腺苷单磷酸增加介导水通道 aquaporin 2 向集合管细胞的顶端膜转运，导致水通透性增加和抗利尿作用。水平衡的临床紊乱很常见，并且已经描述了涉及 AVP 分泌和反应性的许多步骤中的异常。本文重点介绍水平衡的主要紊乱、尿崩症和抗利尿激素分泌不当综合征。
