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钠缺乏、钾缺乏和肝硬化时对血管加压素的升压抵抗

Pressor resistance to vasopressin in sodium depletion, potassium depletion, and cirrhosis.

作者信息

Murray B M, Paller M S

出版信息

Am J Physiol. 1986 Sep;251(3 Pt 2):R525-30. doi: 10.1152/ajpregu.1986.251.3.R525.

DOI:10.1152/ajpregu.1986.251.3.R525
PMID:2875660
Abstract

Resistance to the pressor effects of angiotensin II, but not norepinephrine, has been observed in sodium depletion, potassium depletion, and cirrhosis. We tested the response to arginine vasopressin (AVP) in each of these conditions. Male Sprague-Dawley rats were made sodium depleted with furosemide and a low-sodium diet for 3 days, potassium depleted by feeding a low-potassium diet for 14-21 days, or cirrhotic by inhalation of carbon tetrachloride for 8 wk. In conscious rats, the pressor response to graded doses of AVP was reduced in sodium depletion by 27-43% compared with control rats. Sodium-depleted rats were also found to have enhanced baroreceptor reflexes, since the decrease in heart rate for a given increase in mean arterial pressure was greater than in control rats. When the ganglionic blocker pentolinium tartrate was given to sodium-depleted rats the pressor response to AVP was restored to control levels. In potassium-depleted rats the pressor response to AVP was 21-52% lower than that in controls, whereas cirrhotic rats also had a blunted response to AVP (14-41% lower than control). However, there was no evidence in either of these two states of enhanced baroreceptor activity, and pretreatment with pentolinium tartrate did not restore the pressor response to normal. Therefore, although resistance to the pressor effect of AVP was found in all three conditions, the mechanism of this effect was different in sodium depletion compared with potassium depletion and cirrhosis. We conclude that resistance to the pressor action of AVP in sodium depletion was secondary to resetting of the baroreceptors.

摘要

在钠缺乏、钾缺乏和肝硬化的情况下,已观察到对血管紧张素II升压作用的抵抗,但对去甲肾上腺素的升压作用无抵抗。我们测试了在上述每种情况下对精氨酸加压素(AVP)的反应。雄性Sprague-Dawley大鼠通过呋塞米和低钠饮食造成钠缺乏3天,通过喂食低钾饮食14 - 21天造成钾缺乏,或通过吸入四氯化碳8周造成肝硬化。在清醒大鼠中,与对照大鼠相比,钠缺乏时对不同剂量AVP的升压反应降低了27% - 43%。还发现钠缺乏的大鼠压力感受器反射增强,因为在平均动脉压给定升高时心率的下降幅度大于对照大鼠。当给钠缺乏的大鼠注射神经节阻滞剂酒石酸喷托铵时,对AVP的升压反应恢复到对照水平。在钾缺乏的大鼠中,对AVP的升压反应比对照低21% - 52%,而肝硬化大鼠对AVP的反应也减弱(比对照低14% - 41%)。然而,在这两种状态下均没有证据表明压力感受器活性增强,并且用酒石酸喷托铵预处理并未使升压反应恢复正常。因此,尽管在所有三种情况下均发现对AVP升压作用的抵抗,但与钾缺乏和肝硬化相比,钠缺乏时这种作用的机制有所不同。我们得出结论,钠缺乏时对AVP升压作用的抵抗是压力感受器重新设定的结果。

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