Gerdts E, Myking O L, Omvik P
Department of Heart Disease, Haukeland Hospital, Bergen, Norway.
Blood Press. 1994 Nov;3(6):375-80. doi: 10.3109/08037059409102290.
Thirty men with essential hypertension were examined at three different levels of sodium intake, containing 135, 44 and 290 mmol sodium per day, respectively. Ten patients who increased their 24 hour mean ambulatory blood pressure 10% or more when going from low to high sodium intake were defined as salt sensitive, the others as salt resistant. The casual and 24 hour ambulatory blood pressure measurements defined partly different patients as salt sensitive. In multiple regression analysis, salt sensitivity was associated with an increase in diuresis during low sodium intake, demonstrating a dissociation between water and sodium excretion during salt depletion in the salt sensitive group. The change 24 hour ambulatory blood pressure during salt repletion was positively correlated to the increase in the atrial natriuretic peptide (p < 0.01), and inversely correlated to the plasma concentration of atrial natriuretic peptide after salt depletion (p < 0.01). No difference in plasma norepinephrine, renin, aldosterone, plasma volume, blood volume or 24 hour sodium excretion was found between salt sensitive and salt resistant subjects. We conclude that salt sensitivity is difficult to describe as an entity, but seems to be associated with lower levels of atrial natriuretic peptide and a different response to salt depletion.
对30名原发性高血压男性患者在三种不同钠摄入量水平下进行了检查，三种水平的钠摄入量分别为每天135、44和290毫摩尔。10名患者在从低钠摄入转为高钠摄入时，其24小时平均动态血压升高10%或更多，被定义为盐敏感型，其他患者为盐抵抗型。偶然测量和24小时动态血压测量确定的盐敏感型患者部分不同。在多元回归分析中，盐敏感性与低钠摄入期间尿量增加有关，表明盐敏感组在盐耗竭期间水和钠排泄之间存在分离。补盐期间24小时动态血压变化与心房利钠肽增加呈正相关（p<0.01），与盐耗竭后心房利钠肽血浆浓度呈负相关（p<0.01）。盐敏感型和盐抵抗型受试者之间在血浆去甲肾上腺素、肾素、醛固酮、血浆容量、血容量或24小时钠排泄方面未发现差异。我们得出结论，盐敏感性难以作为一个单一实体来描述，但似乎与较低水平的心房利钠肽以及对盐耗竭的不同反应有关。
