Favre H, Mach R S
Schweiz Med Wochenschr. 1980 Jul 19;110(29):1107-11.
The pathophysiological basis of idiopathic edema is not yet fully understood. To elucidate further the mechanism by which this syndrome occurs, natriuretic factor (NF) has been measured in the urine of 10 female patients with idiopathic edema receiving a diet containing 3-4 g NaCl a day. Twenty-four hour urines collected on an ambulatory basis were fractionated through a G-25 Sephadex column and fraction IV, which has been previously shown to possess natriuretic activity, was tested on a rat assay. Five of these patients exhibited NF activity averaging 183.2 +/- 68.7%, which was in agreement with their salt intake. In contrast, the remaining 5 patients have very high NF activity (1462.6 +/- 273.2%) on the same diet. An additional patient studied for 9 days under metabolic conditions and receiving 120 mEq NaCl a day retained the sodium ingested and gained 5.1 kg body weight. The NF activity increased from 367 to 2616% over the 9 day observation period, although no diuresis occurred at any time. In conclusion, 50% of the patients with idiopathic edema exhibited peripheral resistance to the action of the NF, a fact which may explain the syndrome. It may further serve to differentiate patients with "true idiopathic edema" from those with diuretics abuse.
特发性水肿的病理生理基础尚未完全明确。为了进一步阐明该综合征的发生机制，对10名接受每日摄入3 - 4克氯化钠饮食的特发性水肿女性患者的尿液进行了利钠因子（NF）测定。在动态情况下收集的24小时尿液通过G - 25葡聚糖凝胶柱进行分离，先前已证明具有利钠活性的组分IV在大鼠试验中进行检测。其中5名患者表现出NF活性，平均为183.2±68.7%，这与其盐摄入量相符。相比之下，其余5名患者在相同饮食下具有非常高的NF活性（1462.6±273.2%）。另外一名患者在代谢条件下进行了9天的研究，每天摄入120毫当量氯化钠，摄入的钠潴留，体重增加了5.1千克。在9天的观察期内，NF活性从367%增加到2616%，尽管在任何时候都没有发生利尿。总之，50%的特发性水肿患者表现出对NF作用的外周抵抗，这一事实可能解释了该综合征。它可能进一步有助于将“真正的特发性水肿”患者与利尿剂滥用患者区分开来。
