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呼吸衰竭患者的抗利尿激素(ADH)、醛固酮(PA)及肾素活性(PRA)

[ADH (anti-diuretic hormone), aldosterone (PA) and renin activity (PRA) in patients with respiratory failure].

作者信息

Nakamata M, Tsukioka K, Hashimoto T

出版信息

Nihon Kyobu Shikkan Gakkai Zasshi. 1989 Aug;27(8):933-40.

PMID:2693788
Abstract

Plasma ADH, PA and PRA in patients with respiratory failure (RF) were studied. RF patients were divided into 4 groups, i.e. acute RF (ARF) and chronic RF (CRF), with or without hypercapnia. The levels of these hormones were significantly higher in RF than those in control subjects, moreover, they were markedly elevated in ARF than those in CRF. In multiple regression analysis, ADH correlated with PaO2, pH and PRA in RF patients, but correlated with serum osmolality in control subjects. It was considered that ADH in RF was affected by the direct effect of blood gases and circulatory disorder. The mechanism of elevated PA and PRA in RF probably was mediated through restriction of intake of water and Na, reduction of renal blood flow and decreased ACE often occurred in RF. Abnormally elevated hormones are more often recognized in edematous patients than in nonedematous patients. It was suggested that many patients with RF develop heart failure or edema due to hormonal abnormalities.

摘要

对呼吸衰竭(RF)患者的血浆抗利尿激素(ADH)、醛固酮(PA)和肾素活性(PRA)进行了研究。RF患者被分为4组,即急性RF(ARF)和慢性RF(CRF),伴有或不伴有高碳酸血症。这些激素的水平在RF患者中显著高于对照组,此外,在ARF中比在CRF中明显升高。在多元回归分析中,RF患者中ADH与动脉血氧分压(PaO₂)、pH值和PRA相关,但在对照组中与血清渗透压相关。认为RF中的ADH受血气和循环障碍的直接影响。RF中PA和PRA升高的机制可能是通过限制水和钠的摄入、肾血流量减少以及RF中常出现的血管紧张素转换酶(ACE)降低介导的。水肿患者比非水肿患者更常出现激素异常升高。提示许多RF患者因激素异常而发生心力衰竭或水肿。

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