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健康老年男性缺水后口渴感降低。

Reduced thirst after water deprivation in healthy elderly men.

作者信息

Phillips P A, Rolls B J, Ledingham J G, Forsling M L, Morton J J, Crowe M J, Wollner L

出版信息

N Engl J Med. 1984 Sep 20;311(12):753-9. doi: 10.1056/NEJM198409203111202.

Abstract

To determine whether responses to dehydration are altered with age, we investigated the thirst, fluid and electrolyte responses, and hormonal responses to 24 hours of water deprivation in seven healthy active elderly men (67 to 75 years old) and seven healthy young men (20 to 31 years old) who were matched for weight loss during water deprivation. After water deprivation, the older men had greater increases in plasma osmolality, sodium concentration, and vasopressin levels. However, their urinary osmolality was lower and they were less thirsty and drank less after water deprivation, so that their plasma and urine were not diluted to predeprivation levels. Regression analysis indicated increased sensitivity of vasopressin osmoreceptors in the older group, although this difference was not statistically significant. We conclude that after 24 hours of water deprivation, there is a deficit in thirst and water intake in healthy elderly men, as compared with younger men, although vasopressin osmoreceptor responsiveness is maintained or even increased. Our findings also suggest that the well-known deficit in urinary concentrating ability that occurs with age reflects renal causes and not a lack of circulating vasopressin.

摘要

为了确定对脱水的反应是否随年龄而改变,我们研究了7名健康活跃的老年男性(67至75岁)和7名健康年轻男性(20至31岁)在24小时禁水期间的口渴、液体和电解质反应以及激素反应,这些男性在禁水期间体重减轻情况相匹配。禁水后,老年男性的血浆渗透压、钠浓度和血管加压素水平升高幅度更大。然而,他们的尿渗透压较低,禁水后口渴感较轻且饮水量较少,因此他们的血浆和尿液并未稀释到禁水前的水平。回归分析表明老年组血管加压素渗透压感受器的敏感性增加,尽管这种差异无统计学意义。我们得出结论,与年轻男性相比,健康老年男性在24小时禁水后,口渴和水摄入量存在不足,尽管血管加压素渗透压感受器的反应性得以维持甚至增强。我们的研究结果还表明,随着年龄增长出现的众所周知的尿浓缩能力缺陷反映的是肾脏原因,而非循环血管加压素缺乏。

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