血管加压素在手术期间及术后对溶质和水排泄的影响。
The effect of vasopressin on solute and water excretion during and after surgical operations.
作者信息
Fieldman N R, Forsling M L, Le Quesne L P
出版信息
Ann Surg. 1985 Mar;201(3):383-90. doi: 10.1097/00000658-198503000-00022.
The relationship between the concentration of plasma arginine vasopressin (AVP), urine volume, and osmolality during and after an abdominal operation was studied in nine patients. In all patients the AVP level rose well above that necessary for maximal antidiuresis (5 fmol ml-1) and then returned to within the normal range (0.5-5.0 fmol ml-1) usually over the next 24 hours. During this period of raised AVP concentration the urine volume, which varied considerably, was closely related to osmolar excretion. With the fall of AVP to normal levels, all but one of the patients eventually exhibited positive free water clearance. However, in most patients the urine remained hypertonic for some hours and its volume continued to be determined mainly by osmolar load which was itself apparently related to glomerular filtration rate. At no time was there a significant relationship between changes in plasma AVP concentration and urinary volume.
对9例患者腹部手术期间及术后血浆精氨酸加压素（AVP）浓度、尿量和尿渗透压之间的关系进行了研究。所有患者的AVP水平均升至远高于最大抗利尿所需水平（5 fmol/ml），然后通常在接下来的24小时内恢复至正常范围（0.5 - 5.0 fmol/ml）。在AVP浓度升高期间，尿量变化很大，与渗透物质排泄密切相关。随着AVP降至正常水平，除1例患者外，所有患者最终均表现出正的自由水清除率。然而，在大多数患者中，尿液在数小时内仍为高渗，其体积继续主要由渗透物质负荷决定，而渗透物质负荷本身显然与肾小球滤过率有关。血浆AVP浓度变化与尿量之间在任何时候均无显著关系。
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