Seif S M, Robinson A G, Zimmerman E A, Wilkins J
Endocrinology. 1978 Oct;103(4):1009-15. doi: 10.1210/endo-103-4-1009.
Impaired excretion of a water load is known to occur in adrenal insufficiency and to be corrected by administration of glucocorticoid. Such impairment has been related to either a loss of a permissive effect of glucocorticoids on the diluting segments of the nephron or to an alteration of release, turnover, or action of antidiuretic hormone. Specific and sensitive RIAs for arginine vasopressin and neurophysin were utilized to measure plasma and pituitary levels of neurohypophyseal peptides at baseline and after an intragastrically administered water load. Conscious, unanesthetized, and nonstressed sham-operated, adrenalectomized, and adrenalectomized prednisone-treated rats were studied. The results demonstrate a significant elevation in vasopressin and neurophysin in plasma in adrenalectomized rats maintained in a normal state of hydration. After water loading, the adrenalectomized rats diluted their plasma osmolality but had a decreased urinary volume, increased urinary osmolality, and elevated vasopressin and neurophysin in their plasma. In the pituitary, vasopressin and neurophysin were depleted in adrenalectomized rats, indicating increased secretion of these peptides. It is concluded that elevated vasopressin in plasma may be an important factor in the incomplete water diuresis in adrenal insufficiency.
已知在肾上腺功能不全时会出现水负荷排泄受损的情况,而给予糖皮质激素可纠正这种损害。这种损害与糖皮质激素对肾单位稀释段的允许作用丧失有关,或者与抗利尿激素的释放、周转或作用改变有关。利用精氨酸加压素和神经垂体素的特异性和灵敏放射免疫分析法,在基线以及胃内给予水负荷后,测量神经垂体肽的血浆和垂体水平。对清醒、未麻醉且未受应激的假手术、肾上腺切除以及肾上腺切除并用泼尼松治疗的大鼠进行了研究。结果表明,处于正常水合状态的肾上腺切除大鼠血浆中的加压素和神经垂体素显著升高。水负荷后,肾上腺切除大鼠的血浆渗透压降低,但其尿量减少、尿渗透压升高,血浆中的加压素和神经垂体素升高。在垂体中,肾上腺切除大鼠的加压素和神经垂体素减少,表明这些肽的分泌增加。得出的结论是,血浆中加压素升高可能是肾上腺功能不全时水利尿不完全的一个重要因素。