Leimbach W N, Schmid P G, Mark A L
Am J Physiol. 1984 Oct;247(4 Pt 2):H638-44. doi: 10.1152/ajpheart.1984.247.4.H638.
We postulated an interaction between the osmoreceptor and baroreceptor regulation of arginine vasopressin (AVP) release in humans such that the modulating effects of the baroreceptors on AVP release may be undetectable unless the serum osmolality is elevated. We studied normal subjects in both a water-replete (WR, n = 9) and water-deplete (WD, n = 9) state. We monitored blood pressure, central venous pressure, and forearm blood flow. In both WR and WD subjects selective unloading of cardiac baroreceptors with lower body negative pressure (LBNP) -15 mmHg for 30 min did not increase AVP levels. Combined unloading of cardiac and arterial baroreceptors by LBNP -40 mmHg for 10 min significantly increased AVP levels in only the fluid-deplete group [3.54 +/- 0.40 to 8.09 +/- 1.40 (SE) microU/ml, control vs. LBNP -40 mmHg, P less than 0.05]. Mean arterial pressures did not decrease with LBNP -40 mmHg for 10 min. Further analysis of the data based on serum osmolalities (OSM) indicated that LBNP -40 mmHg significantly increased AVP levels (3.72 +/- 0.43 to 13.59 +/- 3.63 microU/ml; P less than 0.05; n = 9) during sessions with OSM greater than 294 mosmol/kg, but not during sessions with OSM less than 294 mosmol/kg (2.85 +/- 0.29 to 4.66 +/- 1.15 microU/ml; P = NS; n = 11). This study demonstrates that significant baroreflex-mediated regulation of vasopressin can occur in humans in the absence of overt hypotension. Second, it reveals an interaction between osmoreceptor and baroreceptor regulation of vasopressin levels in humans such that physiological unloading of cardiac and arterial baroreceptors significantly increases plasma vasopressin levels only when serum osmolality is increased.
我们推测,人体中渗透压感受器与压力感受器对精氨酸加压素(AVP)释放的调节之间存在相互作用,即除非血清渗透压升高,否则压力感受器对AVP释放的调节作用可能无法检测到。我们研究了处于水负荷充足(WR,n = 9)和缺水(WD,n = 9)状态的正常受试者。我们监测了血压、中心静脉压和前臂血流量。在WR和WD受试者中,用-15 mmHg的下体负压(LBNP)选择性卸载心脏压力感受器30分钟,并未增加AVP水平。用-40 mmHg的LBNP联合卸载心脏和动脉压力感受器10分钟,仅在缺水组显著增加了AVP水平[3.54±0.40至8.09±1.40(SE)微单位/毫升,对照组与LBNP -40 mmHg,P<0.05]。平均动脉压在-40 mmHg的LBNP作用10分钟时并未降低。根据血清渗透压(OSM)对数据进行的进一步分析表明,在OSM大于294毫摩尔/千克的实验过程中,-40 mmHg的LBNP显著增加了AVP水平(3.72±0.43至13.59±3.63微单位/毫升;P<0.05;n = 9),但在OSM小于294毫摩尔/千克的实验过程中未增加(2.85±0.29至4.66±1.15微单位/毫升;P =无显著性差异;n = 11)。本研究表明,在没有明显低血压的情况下,人体中可发生显著的压力反射介导的血管加压素调节。其次,它揭示了人体中渗透压感受器与压力感受器对血管加压素水平调节之间的相互作用,即只有当血清渗透压升高时,心脏和动脉压力感受器的生理性卸载才会显著增加血浆血管加压素水平。