Delva N J, Crammer J L, Lawson J S, Lightman S L, Sribney M, Weier B J
Department of Psychiatry, Queen's University, Kingston, Ontario, Canada.
Br J Psychiatry. 1990 Nov;157:703-12. doi: 10.1192/bjp.157.5.703.
Twelve chronic in-patients with primary polydipsia were studied, during free drinking and after fasting, by concurrent measurements of plasma AVP, serum sodium and osmolality, and urine volume, AVP, osmolality, and creatinine. A majority of the patients showed inappropriately high levels of AVP: plasma AVP estimations demonstrated that seven had Type I SIADH and two had Type II SIADH. Urinary AVP estimations confirmed inappropriately raised AVP in seven of the subjects tested, and there was a significant agreement between the plasma and urine diagnoses. Although able to concentrate their urine in response to fluid deprivation, the patients showed a decreased renal sensitivity to AVP. Despite the mitigating effect of decreased renal sensitivity to AVP, the SIADH seen in these patients appears to contribute to the development of water intoxication caused by polydipsia.
对12例原发性烦渴的慢性住院患者进行了研究，在自由饮水期间和禁食后，同时测量血浆血管加压素（AVP）、血清钠和渗透压，以及尿量、AVP、渗透压和肌酐。大多数患者的AVP水平异常升高：血浆AVP测定显示，7例为Ⅰ型抗利尿激素分泌异常综合征（SIADH），2例为Ⅱ型SIADH。尿AVP测定证实，在接受检测的7名受试者中AVP升高异常，血浆和尿液诊断结果之间存在显著一致性。尽管患者能够因液体剥夺而浓缩尿液，但他们对AVP的肾脏敏感性降低。尽管肾脏对AVP的敏感性降低有缓解作用，但这些患者中出现的SIADH似乎促成了烦渴引起的水中毒的发展。
