Diez J, Simon M A, Anton F, Indart F J, Prieto J
Department of Medicine, School of Medicine, University of Zaragoza, Spain.
Eur J Clin Invest. 1990 Jun;20(3):266-71. doi: 10.1111/j.1365-2362.1990.tb01854.x.
The proximal and distal sodium reabsorption were calculated from lithium clearance in 21 healthy controls and 24 cirrhotic patients with ascites after 4 days under a sodium-restricted diet. The values of fractional lithium clearance were lower in patients than in controls (7.37 +/- 0.87 vs. 18.13 +/- 1.76%, P less than 0.001). Fractional proximal sodium reabsorption was increased in patients compared with controls (92.8 +/- 1.1 vs. 81.8 +/- 1.7%, P less than 0.001). No differences were found in fractional distal sodium reabsorption between controls and patients (96.9 +/- 0.8 vs. 98.6 +/- 0.1%). When patients were separated into two subgroups according to their sodium balance, it was found that fractional distal sodium reabsorption was increased in patients whose balance remained positive, compared with patients on a negative sodium balance (98.99 +/- 0.26 vs. 94.11 +/- 1.50%, P less than 0.05). In addition, the natriuretic response to a specific dose of spironolactone was higher in patients on positive sodium balance compared with patients on negative sodium balance (per cent increase in natriuresis after spironolactone 300 mg day-1: 355.24 +/- 73.98 vs. 84.21 +/- 15.8%, P less than 0.01). We conclude that proximal sodium reabsorption is increased in cirrhotics with ascites. In addition, distal sodium reabsorption is enhanced only in those patients which exhibit avid sodium retention.
在21名健康对照者和24名肝硬化腹水患者中，在限钠饮食4天后，根据锂清除率计算近端和远端钠重吸收。患者的锂清除率分数值低于对照组（7.37±0.87对18.13±1.76%，P<0.001）。与对照组相比，患者的近端钠重吸收分数增加（92.8±1.1对81.8±1.7%，P<0.001）。对照组和患者之间的远端钠重吸收分数没有差异（96.9±0.8对98.6±0.1%）。当根据钠平衡将患者分为两个亚组时，发现钠平衡仍为正的患者与钠平衡为负的患者相比，远端钠重吸收分数增加（98.99±0.26对94.11±1.50%，P<0.05）。此外，钠平衡为正的患者对特定剂量螺内酯的利钠反应高于钠平衡为负的患者（螺内酯300mg/天-1后利钠增加百分比：355.24±73.98对84.21±15.8%，P<0.01）。我们得出结论，肝硬化腹水患者近端钠重吸收增加。此外，仅在那些表现出强烈钠潴留的患者中远端钠重吸收增强。
