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甘露醇诱导的脑脊液钠减少对参与体液平衡控制的神经和内分泌机制的影响。

Influence of mannitol-induced reduction in CSF Na on nervous and endocrine mechanisms involved in the control of fluid balance.

作者信息

Leksell L G, Congiu M, Denton D A, Fei D T, McKinley M J, Tarjan E, Weisinger R S

出版信息

Acta Physiol Scand. 1981 May;112(1):33-40. doi: 10.1111/j.1748-1716.1981.tb06779.x.

Abstract

Infusions (20 microliter/min) of isotonic (0.27 M) and hypertonic (0.7 M) mannitol dissolved in Na-free artificial CSF were made for 1 h. into the lateral cerebral ventricle (IVT) of conscious water-replete sheep. The IVT infusion of both 0.27 M and 0.7 M mannitol induced a water-diuresis. Samples of CSF were collected prior to, and 5, 35, 65, 125 min after the end of the infusion. These consistently showed a reduction in CSF [Na], while CSF osmolality remained unchanged after 0.27 M mannitol, and was considerably increased after 0.7 M mannitol. In the 44 dehydrated sheep IVT infusion of 0.7 mannitol in Na-free artificial CSF was made for 6 h. The water deprivation as such caused a marked increase in plasma and CSF [Na] and osmolality. The 6 h IVT infusion of hypertonic mannitol further increased the CSF osmolality, while CSF [Na] decreased and reached a values below the normal for water-replete animals. The infusion also induced a fall in plasma ADH resulting in a water-diuresis, and extinguished the thirst of the dehydrated sheep. Furthermore, the infusion markedly reduced renal sodium excretion with causing any substantial change in blood aldosterone, in spite of the fact that there was a conspicuous increase in plasma renin concentration. The study supports the view that sodium sensitive receptors close to the cerebral ventricular system participate in the regulation of ADH secretion, water intake, renin release, and renal sodium excretion.

摘要

将溶解于无钠人工脑脊液中的等渗(0.27M)和高渗(0.7M)甘露醇以20微升/分钟的速度输注到清醒且水合状态良好的绵羊侧脑室(IVT)中,持续1小时。0.27M和0.7M甘露醇的IVT输注均诱导了水利尿。在输注结束前以及结束后5、35、65、125分钟采集脑脊液样本。这些样本始终显示脑脊液[Na]降低,而0.27M甘露醇后脑脊液渗透压保持不变,0.7M甘露醇后则显著升高。在44只脱水绵羊中,将无钠人工脑脊液中的0.7M甘露醇IVT输注6小时。单纯的缺水导致血浆和脑脊液[Na]以及渗透压显著升高。6小时的高渗甘露醇IVT输注进一步增加了脑脊液渗透压,而脑脊液[Na]降低并达到低于水合状态良好动物正常水平的值。输注还导致血浆抗利尿激素下降,从而引起水利尿,并消除了脱水绵羊的口渴感。此外,尽管血浆肾素浓度明显升高,但输注显著降低了肾钠排泄,而未引起血醛固酮的任何实质性变化。该研究支持这样一种观点,即靠近脑室系统的钠敏感受体参与抗利尿激素分泌、水摄入、肾素释放和肾钠排泄的调节。

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