Marcondes M, Genta E N
Am J Med Sci. 1977 Mar-Apr;273(2):185-92. doi: 10.1097/00000441-197703000-00008.
The antidiuretic action of chlorpropamide was studied in 10 diabetes insipidus patients sensitive to vasopressin and 15 normal subjects. After an oral load of water followed by sustained hydration through water ingestion in a volume equivalent to the urinary flow, chlorpropamide (4 mg/kg body weight) was intravenously administered as a single dose, either alone (34 experiments) or simultaneously with pitressin infusion (6 experiments). During the experiments, creatinine clearance as well as osmolal and plasma and urine electrolyte concentrations were measured. Several urine collection periods were made before and after the administration of chlorpropamide. In thes experimental conditions, chlorpropamide promoted a marked antidiuresis (p less than 0.01) in patients with diabetes insipidus and presented no antidiuretic effect (p greater than 0.01) in normal subjects, even with a double dose. However, if previously to the experiment, the normal individuals were dehydrated (mean weight loss of 4.8 per cent) or the diabetes insipidus patients were hydrated (mean weight gain of 6.4 per cent) a reverse behavior was observed: that is, the normal subjects did present (p less than 0.01) and the diabetes insipidus patients did not present (p greater than 0.01) antidiuresis to chlorpropamide. The results suggest that the state of hydration modulates the action of chlorpropamide in a way apparently independent of the antiduretic hormone.
对10名对加压素有反应的尿崩症患者和15名正常受试者研究了氯磺丙脲的抗利尿作用。经口服水负荷后，通过摄入与尿流量相当的水量进行持续水合，然后静脉单剂量给予氯磺丙脲（4mg/kg体重），单独给药（34次实验）或同时输注垂体后叶素（6次实验）。实验期间，测量肌酐清除率以及渗透压、血浆和尿液电解质浓度。在给予氯磺丙脲前后进行了几个尿液收集期。在这些实验条件下，氯磺丙脲在尿崩症患者中促进了明显的抗利尿作用（p<0.01），而在正常受试者中即使给予双倍剂量也无抗利尿作用（p>0.01）。然而，如果在实验前，正常个体脱水（平均体重减轻4.8%）或尿崩症患者水合（平均体重增加6.4%），则观察到相反的情况：即正常受试者出现（p<0.01）而尿崩症患者未出现（p>0.01）对氯磺丙脲的抗利尿作用。结果表明，水合状态以明显独立于抗利尿激素的方式调节氯磺丙脲的作用。
