Gallardo Valverde J M, Padillo Ruiz F J, Rodríguez Quirós M, Gómez Alvarez M, Naranjo Rodríguez A, Martín Malo A, Puente Gutiérrez J, Miño Fugarolas G, Sitges-Serra A, Pera Madrazo C
Departamento de Cirugía, Hospital Universitario Reina Sofía, Córdoba.
Gastroenterol Hepatol. 1998 Jan;21(1):1-5.
The alteration of the mechanisms of water and sodium preservation may be an important factor in the development of acute postoperative renal failure in obstructive jaundice (OJ). Experimental OJ has been associated with a depletion of the extracellular volume and alteration of the mechanisms of regulation of hydrosaline metabolism. The aim of this study was to evaluate the distribution of the body volumes and the regulating hormones of hydrosaline metabolism in human OJ.
A prospective, clinical study evaluating 18 patients with OJ (9 females and 9 males) with a mean age of 69 +/- 8.9 years was performed. The plasma levels of antinatriuretic peptide (ANP), aldosterone and renin were determined. The body volumes were evaluated by tetrapolar bioimpedanciometry. The results of the patients with OJ were compared with a control group (CG) of 12 healthy subjects, matched for age and sex (6 females and 6 males with a mean age of 64.5 +/- 14 years).
High ANP values were observed in 87.5% of the patients. The results of the hormonal studies compared with the CG were: ANP (117.33 +/- 37.7 vs 41.31 +/- 16.8 pg/ml; p < 0.001), aldosterone (185.68 +/- 82.1 vs 44.3 +/- 21.6 pg/ml; p < 0.001) and renine (57.18 +/- 69.9 vs 16.08 +/- 9.7 microU/ml; p < 0.05). Depletion of extracellular volume was found in 75% of the patients.
Human obstructive jaundice is associated with an important alteration in the hormonal mechanisms of water and sodium regulation. This alteration is accompanied by a marked depletion of extracellular volume.
水钠潴留机制的改变可能是梗阻性黄疸（OJ）术后急性肾衰竭发生发展的一个重要因素。实验性OJ与细胞外液量减少及水盐代谢调节机制改变有关。本研究旨在评估人OJ患者的身体容积分布及水盐代谢调节激素情况。
进行了一项前瞻性临床研究，评估18例OJ患者（9例女性和9例男性），平均年龄69±8.9岁。测定了血浆中利钠肽（ANP）、醛固酮和肾素水平。通过四极生物电阻抗分析法评估身体容积。将OJ患者的结果与12名年龄和性别匹配的健康受试者组成的对照组（CG）进行比较（6例女性和6例男性，平均年龄64.5±14岁）。
87.5%的患者ANP值较高。与CG相比，激素研究结果如下：ANP（117.33±37.7对41.31±16.8 pg/ml；p<0.001）、醛固酮（185.68±82.1对44.3±21.6 pg/ml；p<0.001）和肾素（57.18±69.9对16.08±9.7微单位/毫升；p<0.05）。75%的患者存在细胞外液量减少。
人梗阻性黄疸与水钠调节激素机制的重要改变有关。这种改变伴随着细胞外液量的显著减少。
