Widecka K, Krzyzanowska-Swiniarska B, Celibała R, Gruszczyńska M, Goździk J, Ciechanowski K, Czekalski S
Kliniki Endokrynologii i Chorób Przemiany Materii, Pomorskiej Akademii Medycznej w Szczecinie.
Pol Arch Med Wewn. 1993 Feb;89(2):117-24.
The aim of this work was an evaluation of the effect of the acute hypervolemia induced by 90 min intravenous infusion of 1500 ml 0.9% NaCl (16.7 ml/min) on blood pressure, plasma concentration of the atrial natriuretic peptide (ANP), cyclic guanosine monophosphate (cGMP), aldosterone (ALDO), plasma renin activity (PRA) in patients with essential hypertension on the normal, low and high sodium intake. Twelve patients with noncomplicated essential sodium-sensitive arterial hypertension participated in the study. Sodium chloride infusions were performed three times: first--on the fifth day of normal daily sodium u intake (110-120 mmol/day), second--on the fifth day of low sodium intake (10-20 mmol/day), third--on the fifth day of high sodium intake (200-220 mmol/day). Acute intravenous sodium chloride load induced a significant increase of the mean arterial pressure (MBP) only when the patients were on the high sodium diet. This increase of the MBP was associated with a significantly lower increment of plasma ANP, cGMP, lower decrement of ALDO and PRA when compared to normal- or low- sodium intake. The results suggest an impairment of the adaptive homeostatic mechanisms induced by an acute intravenous sodium load in patients with noncomplicated salt-sensitive essential hypertension ingesting high-sodium diet.
本研究旨在评估对原发性高血压患者在正常、低钠和高钠摄入情况下,静脉输注1500 ml 0.9%氯化钠(16.7 ml/分钟,共90分钟)所诱导的急性高血容量对血压、心房利钠肽(ANP)血浆浓度、环磷酸鸟苷(cGMP)、醛固酮(ALDO)、血浆肾素活性(PRA)的影响。12例无并发症的原发性钠敏感性动脉高血压患者参与了该研究。氯化钠输注进行了三次:第一次——在正常每日钠摄入量(110 - 120 mmol/天)的第五天,第二次——在低钠摄入量(10 - 20 mmol/天)的第五天,第三次——在高钠摄入量(200 - 220 mmol/天)的第五天。仅当患者处于高钠饮食时,急性静脉输注氯化钠负荷才会导致平均动脉压(MBP)显著升高。与正常或低钠摄入相比,MBP的这种升高与血浆ANP、cGMP的显著较低增幅以及ALDO和PRA的较低降幅相关。结果表明,在摄入高钠饮食的无并发症盐敏感性原发性高血压患者中,急性静脉钠负荷诱导的适应性稳态机制受损。