Decaux G, Crenier L, Namias B, Gervy C, Soupart A
Department of Internal Medicine, Erasmus University Hospital, Free University, Brussels, Belgium.
J Lab Clin Med. 1994 Jun;123(6):892-8.
The effects of acute and chronic water intoxication induced by the administration of oral water and arginine vasopressin (AVP) or 1-deamino-8-D-arginine-vasopressin (DDAVP) on blood acid-base equilibrium and aldosterone, corticosterone, and thyroxine secretion were studied in rats. Acute hyponatremia (3 hours) was associated with normal bicarbonate and blood acid-base equilibrium and a decrease in aldosterone and thyroxine concentrations, while corticosterone was increased. When similar levels of hyponatremia (serum sodium 110 mEq/L) were maintained for 24 or 72 hours, a normal serum bicarbonate concentration was observed, but blood acid-base equilibrium showed a mixed respiratory and metabolic alkalosis. Blood pH was negatively correlated with serum sodium concentration (R = -0.65; p < 0.001), as was the metabolic alkalosis (base excess; R = -0.64; p < 0.001) and the aldosterone concentration (R = -0.52; p < 0.01), while the PCO2 was positively correlated (R = +0.49; p < 0.01). Hyperaldosteronism was similar whether hyponatremia was induced with AVP or DDAVP and was observed even for mild hyponatremia. When hyponatremia was induced by a high water and salt intake (2.5% D-glucose, 0.45% NaCl; 15% body weight), aldosterone concentration was as high (about three times control values) as in rats with similar levels of hyponatremia but with a salt-free diet. The high salt intake was associated with a more severe metabolic alkalosis (base excess +5,5 mEq/L). In chronic hyponatremia, corticosterone and thyroxine values were normal. In hyponatremia related to syndrome of inappropriate secretion of antidiuretic hormone, the normal serum bicarbonate level is an expected observation; as in acute water intoxication, it stays normal.(ABSTRACT TRUNCATED AT 250 WORDS)
研究了经口给予水和精氨酸加压素(AVP)或1-去氨基-8-D-精氨酸加压素(DDAVP)诱导的急性和慢性水中毒对大鼠血液酸碱平衡以及醛固酮、皮质酮和甲状腺素分泌的影响。急性低钠血症(3小时)时,碳酸氢盐和血液酸碱平衡正常,醛固酮和甲状腺素浓度降低,而皮质酮增加。当维持相似水平的低钠血症(血清钠110 mEq/L)24或72小时时,血清碳酸氢盐浓度正常,但血液酸碱平衡表现为混合性呼吸性和代谢性碱中毒。血液pH与血清钠浓度呈负相关(R = -0.65;p < 0.001),代谢性碱中毒(碱剩余;R = -0.64;p < 0.001)和醛固酮浓度(R = -0.52;p < 0.01)也是如此,而PCO2呈正相关(R = +0.49;p < 0.01)。无论低钠血症是由AVP还是DDAVP诱导,醛固酮增多症均相似,甚至在轻度低钠血症时也可观察到。当通过高水盐摄入(2.5% D-葡萄糖,0.45% NaCl;体重的15%)诱导低钠血症时,醛固酮浓度与低钠血症水平相似但无盐饮食的大鼠一样高(约为对照值的三倍)。高盐摄入与更严重的代谢性碱中毒(碱剩余 +5.5 mEq/L)相关。在慢性低钠血症中,皮质酮和甲状腺素值正常。在与抗利尿激素分泌不当综合征相关的低钠血症中,血清碳酸氢盐水平正常是预期的观察结果;与急性水中毒一样,它保持正常。(摘要截短于250字)