Jellinek K, Tulassay T, Verebély T, Rascher W
Orv Hetil. 1989 Oct 22;130(43):2299-300, 2303-4.
Authors investigated the concentration changes of arginine vasopressin (AVP) and of atrial natriuretic peptide (ANP) in plasma. The renal characteristics of water- and sodium metabolism in the first 24 hours of the postoperative period in 11 children operated with acute appendicitis have been studied. Crystalloid infusion was applied in 60 ml/kg/24 h dose, in 5 cases however, 1 g/kg albumin vas also administered during the operation. In children getting crystalloid infusion (group "A") the initial AVP value was 29.9 +/- 8.8 pg/ml, which further increased to 58.2 +/- 15.2 pg/ml (p 0.05) by the 6. postoperative hour and even in the 24. hour it remained above the physiological value (19.9 +/- 5.3 pg/ml). During the observation time significant Na- and water retention developed. The albumin administration (group "B") stopped the further increase of AVP values, the Na-household remained in equilibrium and the water retention developed only in smaller degree. The ANP plasma concentration of both groups was in the normal range and did not change during observation time. Our data show that for the postoperative water retention first of all the increased AVP activity is responsible. The more intensive AVP secretion may be induced by the relative intravascular hypovolemia since by enhancing the plasma volume the further increase of postoperative hormone activity could be prevented.
作者研究了血浆中精氨酸加压素（AVP）和心房利钠肽（ANP）的浓度变化。对11例接受急性阑尾炎手术的儿童术后24小时内水和钠代谢的肾脏特征进行了研究。晶体液以60 ml/kg/24小时的剂量输注，然而，有5例在手术期间还给予了1 g/kg的白蛋白。在接受晶体液输注的儿童（“A”组）中，AVP初始值为29.9±8.8 pg/ml，到术后第6小时进一步升至58.2±15.2 pg/ml（p<0.05），甚至在术后24小时仍高于生理值（19.9±5.3 pg/ml）。在观察期间出现了明显的钠和水潴留。白蛋白给药（“B”组）阻止了AVP值的进一步升高，钠平衡保持稳定，水潴留仅在较小程度上出现。两组的ANP血浆浓度均在正常范围内，且在观察期间没有变化。我们的数据表明，术后水潴留首先是由AVP活性增加引起的。相对血管内血容量不足可能诱导更强烈的AVP分泌，因为通过增加血浆容量可以防止术后激素活性的进一步升高。
