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人体在水浸期间中心静脉压和血浆精氨酸加压素与血容量变化的关系

Central venous pressure and plasma arginine vasopressin in man during water immersion combined with changes in blood volume.

作者信息

Norsk P, Bonde-Petersen F, Warberg J

出版信息

Eur J Appl Physiol Occup Physiol. 1986;54(6):608-16. doi: 10.1007/BF00943349.

DOI:10.1007/BF00943349
PMID:3948857
Abstract

To investigate the influence of central venous pressure (CVP) changes on plasma arginine vasopressin (pAVP), 8 normal male subjects were studied twice before, during and after immersion to the neck in water at 35.1 degrees +/- 0.1 degrees C (mean +/- SE) for 6 h. After 2 h of immersion, blood volume was either expanded (WIEXP) by intravenous infusion of 2.0 1 of isotonic saline during 2 h or reduced by loss of 0.5 1 of blood during 30 min (WIHEM). The two studies were randomised between subjects. WIEXP increased CVP, systolic arterial pressure (SAP), diuresis, natriuresis, kaliuresis and osmolar clearance compared to WIHEM while haematocrit, haemoglobin concentration and urine osmolality decreased. Heart rate, mean arterial (MAP) and diastolic arterial pressure, plasma osmolality, plasma sodium, plasma potassium and free water clearance did not differ significantly in the two studies. pAVP was significantly higher after 6 h in WIHEM than after 6 h in WIEXP (2.0 +/- 0.2 vs. 1.6 +/- 0.2 pg X ml-1, mean +/- SE; P less than 0.05). pAVP values were corrected for changes in plasma volume due to infusion in order properly to reflect AVP secretion. In conclusion, there was a weak, but significant, negative correlation between CVP and pAVP during the two studies, while during recovery from WIHEM and WIEXP decrements in SAP and MAP correlated significantly and strongly with increases in pAVP. It is therefore concluded that it is the arterial baroreceptors rather than the cardiopulmonary mechanoreceptors which are of importance in AVP regulation in man.

摘要

为研究中心静脉压(CVP)变化对血浆精氨酸加压素(pAVP)的影响,对8名正常男性受试者在35.1℃±0.1℃(均值±标准误)的水温中浸泡至颈部6小时,在此期间及浸泡前后各进行了两次研究。浸泡2小时后,一部分受试者(WIEXP)在2小时内静脉输注2.0升等渗盐水使血容量增加,另一部分受试者(WIHEM)在30分钟内失血0.5升使血容量减少。两项研究在受试者之间随机分配。与WIHEM相比,WIEXP使CVP、收缩期动脉压(SAP)、利尿、利钠、利钾和渗透清除率增加,而血细胞比容、血红蛋白浓度和尿渗透压降低。两项研究中的心率、平均动脉压(MAP)和舒张期动脉压、血浆渗透压、血浆钠、血浆钾和自由水清除率无显著差异。WIHEM组浸泡6小时后的pAVP显著高于WIEXP组浸泡6小时后的水平(分别为2.0±0.2与1.6±0.2 pg·ml-1,均值±标准误;P<0.05)。为了正确反映抗利尿激素分泌情况,对pAVP值进行了因输注导致的血浆容量变化校正。总之,在两项研究中CVP与pAVP之间存在微弱但显著的负相关,而在WIHEM和WIEXP恢复过程中,SAP和MAP的降低与pAVP的增加显著且强烈相关。因此得出结论,在人类抗利尿激素调节中起重要作用的是动脉压力感受器而非心肺机械感受器。

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