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静息状态下因摄入液体引起的血容量过多:钠浓度的影响

Hypervolemia induced by fluid ingestion at rest: effect of sodium concentration.

作者信息

Sugihara Akira, Fujii Naoto, Tsuji Bun, Watanabe Kazuhito, Niwa Takehiro, Nishiyasu Takeshi

机构信息

Institute of Health and Sport Sciences, University of Tsukuba, Ibaraki, Tsukuba, 305-8574, Japan.

出版信息

Eur J Appl Physiol. 2014 Oct;114(10):2139-45. doi: 10.1007/s00421-014-2933-7. Epub 2014 Jun 25.

Abstract

PURPOSE

Sodium drink is used as a countermeasure against body fluid loss. However, high concentrations of sodium may cause gastrointestinal upset (e.g., diarrhea). We sought to determine the sodium concentration that induces hypervolemia with a minimal risk of gastrointestinal disturbance.

METHODS

Eight healthy active males rested in a chair and ingested a given amount (16-17 ml kg body mass(-1)) of water (W) or solution containing 60, 120 or 180 mmol l(-1) Na(+) (60, 120 and 180Na trials) in 6 equal portions at 10 min intervals. To standardize their hydration status, subjects consumed the same meal and water 2 h before each trial. Drink trials were performed on separate days, and the order was randomized. The change in plasma volume (PV) from pre-drink status was estimated from the hemoglobin concentration and hematocrit every 30 min for 150 min after initiation of drinking.

RESULTS

Subjects began trials in a euhydrated state, as reflected by their plasma osmolality (in mmol l(-1): W, 289.4 ± 1.4; 60Na, 287.0 ± 3.5; 120Na, 287.6 ± 2.3; 180Na, 288.9 ± 3.3). At 120 min, PV had not increased from the pre-drink value in the W (-0.8 ± 4.5 %) or 60Na (2.4 ± 4.9 %) trials, but it increased to similar degrees in the 120Na (7.2 ± 4.6 %) and 180Na (9.4 ± 6.6 %) trials. No diarrhea was reported in the W or 60Na trials, but it was reported in the 120Na (n = 1) and 180Na (n = 6) trials.

CONCLUSIONS

Beverages containing 120 mmol l(-1) Na(+) induce hypervolemia with a minimum incidence of gastrointestinal problems.

摘要

目的

钠饮料被用作对抗体液流失的对策。然而,高浓度的钠可能会引起胃肠道不适(如腹泻)。我们试图确定能诱发血容量过多且胃肠道紊乱风险最小的钠浓度。

方法

八名健康活跃的男性坐在椅子上休息,并以10分钟的间隔分6等份摄入给定数量(16 - 17毫升/千克体重)的水(W)或含有60、120或180毫摩尔/升钠(60、120和180钠试验)的溶液。为使他们的水合状态标准化,受试者在每次试验前2小时食用相同的餐食并饮水。饮料试验在不同日期进行,顺序随机。在开始饮用后150分钟内,每隔30分钟根据血红蛋白浓度和血细胞比容估算血浆量(PV)相对于饮用前状态的变化。

结果

受试者开始试验时处于正常水合状态,这通过他们的血浆渗透压反映出来(以毫摩尔/升计:W,289.4±1.4;60钠,287.0±3.5;120钠,287.6±2.3;180钠,288.9±3.3)。在120分钟时,W试验(-0.8±4.5%)或60钠试验(2.4±4.9%)中的PV未从饮用前值增加,但在120钠试验(7.2±4.6%)和180钠试验(9.4±6.6%)中PV增加到相似程度。W或60钠试验中未报告腹泻,但120钠试验(n = 1)和180钠试验(n = 6)中报告了腹泻。

结论

含有120毫摩尔/升钠的饮料能诱发血容量过多,且胃肠道问题发生率最低。

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