Smitz S, Legros J J
C R Seances Soc Biol Fil. 1981;175(6):874-81.
We studied a patient with the rare syndrome of chronic hypernatremia associated with a frontal expansive process. The pituitary function was evaluated during dynamic tests bearing on radioimmunoassay of serum neurophysins levels. A test of water restrictionloading was performed during which urine appeared diluted (190-200 mOsm/kg) while the degree of serum osmolality was high (310-317 mOsm/kg). An hemodynamic stimulation resulted in a significant increase in serum neurophysins (from 3.5 +/- 0.3 to 5.5 +/- 0.2 ng/ml). After one intravenous injection of 2 mg nicotine, vomiting was observed, followed by a sharp rising of serum neurophysins levels (from 3.2 +/- 0.5 to 10.6 +/- 0.2 ng/ml). During hypertonic saline infusion, serum osmolality increased from 270 to 310 mOsm/kg, while neurophysins showed no significant change. Such results evidence a selective impairment of the hypothalamic-neurohypophyseal response to osmotic stimuli, with intact mechanisms of non-osmotic stimulation. In this patient, natremia was brought back to normal values by adequate water supply.
我们研究了一名患有与额叶扩张性病变相关的罕见慢性高钠血症综合征的患者。在针对血清神经垂体素水平放射免疫测定的动态试验期间评估了垂体功能。进行了禁水-补液试验，在此期间尿液呈稀释状态（190 - 200 mOsm/kg），而血清渗透压程度较高（310 - 317 mOsm/kg）。血流动力学刺激导致血清神经垂体素显著增加（从3.5±0.3增至5.5±0.2 ng/ml）。静脉注射2 mg尼古丁后，观察到呕吐，随后血清神经垂体素水平急剧上升（从3.2±0.5增至10.6±0.2 ng/ml）。在输注高渗盐水期间，血清渗透压从270增至310 mOsm/kg，而神经垂体素无显著变化。这些结果证明下丘脑 - 神经垂体对渗透刺激的反应存在选择性损害，而非渗透刺激机制完整。在该患者中，通过充足的水供应使血钠恢复至正常水平。
