Stachenfeld N S, DiPietro L, Nadel E R, Mack G W
John B. Pierce Laboratory, Yale University School of Medicine, New Haven, Connecticut 06519, USA.
Am J Physiol. 1997 Jan;272(1 Pt 2):R148-57. doi: 10.1152/ajpregu.1997.272.1.R148.
To test the hypothesis that the inhibitory action of central blood volume expansion on thirst and renal fluid regulation is attenuated with aging, we monitored the drinking and renal responses of dehydrated older (70 +/- 2 yr, n = 6) and younger (24 +/- 1 yr, n = 6) subjects during 195 min of head-out water immersion (HOI), which shifts blood centrally and increases plasma volume (PV). Subjects dehydrated by exercising for 2 h at 36 degrees C in the evening and refraining from fluids overnight before HOI in 34 degrees C water or a seated control in water perfusion suit [time control (TC)] the next morning. Ad libitum water intake was allowed after 15 min of HOI. Dehydration decreased PV by 10.6 +/- 1 and 7.3 +/- 1.8% (P < 0.05) and increased plasma osmolality by 6 +/- 2 and 7 +/- 1 mosmol/kg H2O (P < 0.05) in older and younger subjects, respectively. Thirst ratings increased in both groups, but pre-HOI thirst perception on a line rating scale was lower in older (69 +/- 8 mm) than younger (94 +/- 6 mm, P < 0.05) subjects. Fifteen minutes of HOI restored PV by 7.8 +/- 1.0 and 5.7 +/- 1.0% in older and younger subjects, respectively, but suppressed thirst rating in younger subjects only (P < 0.05). Fluid intake was reduced in HOI compared with TC in younger (6.3 +/- 0.5 vs. 14.3 +/- 2.2 ml/kg, P < 0.05) but not in older (6.7 +/- 2.1 vs. 8.4 +/- 3.3 ml/kg) subjects. During HOI, older subjects had smaller suppression of plasma renin activity and aldosterone concentration but a greater increase in the plasma atrial natriuretic peptide concentration (P[ANP], P < 0.05). HOI increased fractional sodium excretion in both groups, but mean arterial pressure increased only in the older subjects (P < 0.05). We conclude that the inhibitory influence of central volume expansion on thirst and drinking behavior is diminished with aging. Furthermore, in contrast to younger people, HOI natriuresis is associated with exaggerated increases in P[ANP] and arterial blood pressure in older people, suggesting arterial baroreceptors may be involved in the fluid regulatory response to central blood volume expansion in older people.
为了验证随着衰老,中心血容量扩张对口渴及肾液调节的抑制作用会减弱这一假设,我们监测了脱水的老年(70±2岁,n = 6)和年轻(24±1岁,n = 6)受试者在195分钟头低位浸水处理(HOI)期间的饮水及肾脏反应,头低位浸水处理可使血液向中心转移并增加血浆量(PV)。受试者于傍晚在36℃下运动2小时导致脱水,并在HOI前于34℃水中或次日早晨在水灌注服中作为坐位对照[时间对照(TC)]时禁水过夜。HOI 15分钟后允许自由饮水。脱水使老年和年轻受试者的PV分别降低10.6±1%和7.3±1.8%(P<0.05),血浆渗透压分别升高6±2和7±1 mOsm/kg H₂O(P<0.05)。两组的口渴评分均升高,但在直线评分量表上,HOI前老年受试者(69±8 mm)的口渴感知低于年轻受试者(94±6 mm,P<0.05)。15分钟的HOI使老年和年轻受试者的PV分别恢复7.8±1.0%和5.7±1.0%,但仅抑制了年轻受试者的口渴评分(P<0.05)。与TC相比,HOI期间年轻受试者的液体摄入量减少(6.3±0.5 vs. 14.3±2.2 ml/kg,P<0.05),而老年受试者则未减少(6.7±2.1 vs. 8.4±3.3 ml/kg)。HOI期间,老年受试者的血浆肾素活性和醛固酮浓度抑制较小,但血浆心钠素浓度升高幅度较大(P[ANP],P<0.05)。HOI使两组的尿钠排泄分数增加,但仅老年受试者的平均动脉压升高(P<0.05)。我们得出结论,随着衰老,中心血容量扩张对口渴及饮水行为的抑制作用减弱。此外,与年轻人不同,HOI利尿与老年人P[ANP]和动脉血压的过度升高有关,提示动脉压力感受器可能参与老年人对中心血容量扩张的液体调节反应。