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老年人对高渗状态的口渴及液体调节反应。

Thirst and fluid regulatory responses to hypertonicity in older adults.

作者信息

Stachenfeld N S, Mack G W, Takamata A, DiPietro L, Nadel E R

机构信息

John B. Pierce Laboratory, Yale University School of Medicine, New Haven, Connecticut 06519, USA.

出版信息

Am J Physiol. 1996 Sep;271(3 Pt 2):R757-65. doi: 10.1152/ajpregu.1996.271.3.R757.

DOI:10.1152/ajpregu.1996.271.3.R757
PMID:8853401
Abstract

To assess the fluid regulatory responses in aging adults, we measured thirst perception and osmoregulation during and after infusion of hypertonic NaCl) saline in older (72 +/- 2 yr, n = 6) and younger (26 +/- n = 6) subjects. Hypertonic saline was infused at 0.1 min-1.kg-1 for 120 min. On a separate day, the same subjects were infused identically with isotonic saline as a control. After infusion and a 30-min equilibration period, the drank water ad libitum for 180 min. Hypertonic infusion led to graded increases in plasma osmolality (Posm; 18 +/- 2 and 20 +/- 2 mosmol/kgH2O) and percent changes plasma volume (16.2 +/- 1.9 and 18.0 +/- 1.2%) that were in older and younger subjects. Osmotically stimulated increases in thirst (94.8 +/- 18.9 and 88.3 +/- 25.6 mm), assessed on a line rating scale, and plasma arginine vasopressin concentration (6.08 +/- 1.50 and 4.51 +/- 1.37 pg/ml, for older younger, respectively) were also unaffected by age. subsequent hypervolemia, both groups of subjects sufficient water to restore preinfusion levels of Posm. Renal handling of free water and sodium was also unaffected by age during recovery from hypertonic saline infusion, but was significantly lower in older subjects during recovery from saline infusion, resulting in net fluid retention and a significant fall in Posm (6 mosmol/kgH2O). In contrast to earlier reports of a blunted thirst response to dehydration hypertonicity, we found that osmotically stimulated thirst and renal osmoregulation were intact in older adults after hypertonic saline infusion.

摘要

为评估老年人的液体调节反应,我们在老年(72±2岁,n = 6)和年轻(26±岁,n = 6)受试者输注高渗氯化钠盐水期间及之后,测量了口渴感知和渗透压调节。以0.1分钟-1·千克-1的速度输注高渗盐水120分钟。在另一天,相同的受试者以相同方式输注等渗盐水作为对照。输注及30分钟平衡期后,受试者自由饮水180分钟。高渗输注导致老年和年轻受试者的血浆渗透压(Posm;分别为18±2和20±2毫摩尔/千克H2O)和血浆体积百分比变化(16.2±1.9和18.0±1.2%)呈分级增加。在线性评分量表上评估的渗透压刺激引起的口渴增加(分别为94.8±18.9和88.3±25.6毫米)以及血浆精氨酸加压素浓度(老年和年轻受试者分别为6.08±1.50和4.51±1.37皮克/毫升)也不受年龄影响。随后的血容量过多时,两组受试者均饮用了足够的水以恢复输注前的Posm水平。从高渗盐水输注恢复过程中,肾脏对自由水和钠的处理也不受年龄影响,但在等渗盐水输注恢复过程中,老年受试者的处理能力显著降低,导致液体净潴留和Posm显著下降(6毫摩尔/千克H2O)。与早期关于脱水高渗状态下口渴反应减弱的报道相反,我们发现高渗盐水输注后,老年人的渗透压刺激口渴和肾脏渗透压调节功能完好。

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