Vetter H, Vetter W, Beckerhoff R, Glänzer K, Furrer J, Hahn C, Kolloch R, Krück F, Kutz K, Siegenthaler W, Witassek F
Schweiz Med Wochenschr. 1977 Dec 3;107(48):1755-9.
Supine plasma aldosterone and plasma renin activity were determined in patients with cirrhosis of the liver and ascites (n = 10). Most of the patients initially showed an increase in plasma aldosterone and plasma renin activity. However, values within the normal range were observed (plasma aldosterone, n = 3; plasma renin activity, n = 4). In the ascitic fluid renin activity could not be detected, whereas aldosterone concentrations correlated significantly with the respective plasma levels (r = 0.8, p less than 0.01). During therapy with spironolactone alone (n =2) or in combination with furosemide (n = 4), diuresis and natriuresis showed no correlation with changes in plasma aldosterone and/or plasma renin activity. Our results suggest that other factors than renin and aldosterone secretion may be important in the formation of ascites in patients with cirrhosis of the liver. In addition, the inverse correlation between mean arterial blood pressure and plasma renin activity (r = -0.65, p less than 0.05) found in our patients supports the assumption that the increase in renin secretion is probably induced by changes in (renal) hemodynamics.
对患有肝硬化腹水的患者（n = 10）测定了仰卧位血浆醛固酮和血浆肾素活性。大多数患者最初血浆醛固酮和血浆肾素活性升高。然而，也观察到了在正常范围内的值（血浆醛固酮，n = 3；血浆肾素活性，n = 4）。腹水中未检测到肾素活性，而醛固酮浓度与相应血浆水平显著相关（r = 0.8，p < 0.01）。在单独使用螺内酯治疗期间（n = 2）或与呋塞米联合治疗期间（n = 4），利尿和利钠与血浆醛固酮和/或血浆肾素活性的变化无相关性。我们的结果表明，除肾素和醛固酮分泌外的其他因素可能在肝硬化患者腹水形成中起重要作用。此外，我们的患者中发现平均动脉血压与血浆肾素活性呈负相关（r = -0.65，p < 0.05），这支持了肾素分泌增加可能是由（肾脏）血流动力学变化引起的假设。
