急性静脉盐水负荷与慢性盐负荷试验在盐敏感性检测的对照研究

目的探讨急性静脉盐水负荷试验盐敏感性个体的检出与慢性盐负荷试验的一致性。方法２３例血压正常健康志愿者先后进行慢性盐负荷试验和急性静脉盐水负荷试验。前者高盐与低盐饮食期各７天，每日摄盐量分别为２３ｇ和３ｇ。后者于４ｈ内静脉输注０．９％盐水２０００ｍｌ，２ｈ后服速尿４０ｍｇ，观察血压直至服速尿２ｈ末。结果慢性与急性盐负荷试验的盐敏感性个体检出符合率为１００％；二者对盐负荷的血压增幅反应相关性良好（ｒ＝０．８５，Ｐ＜０．０１）。慢性盐负荷试验高盐期的血压明显升高发生持续到盐负荷中的第６天，而低盐期的减幅反应出现在第３天。结论急性静脉盐水负荷试验盐敏感性的检出与慢性盐负荷试验完全一致，前者可以替代后者用于人群盐敏感性的检测。

A Comparison of Acute Venous Saline Load with Chronic Dietary Salt Load Test in Determination of Salt Sensitivity

Aim To compare the relationship between acute venous saline load and chronic dietary salt load test. Methods Twenty three cases of normotensive volunteers initially underwent dietary protocol consisting of 7 days of high sodium diet(23 g/d) and 7 days of low sodium diet(3 g/d). Subsequently the same subjects were studied with a protocol of saline infusion induced by intravenous administration of 2000 ml of 0 9% saline over a 4 hours period followed by 40 mg oral dose of furosemide. Results The salt sensitive individuals determined by chronic salt load and acute saline load test respectively were consistent. A positive correlation ( r =0 85, P <0 01) was observed between the blood pressure responses to the two separate techniques. The blood pressure increased significantly in the 6th day during the period of sodium load,and the decrement of blood pressure usually occurred in the 3rd day after sodium depletion. Conclusion These findings showed the consistency of acute venous saline load and chronic dietary salt load for the assessment of blood pressure responses to sodium. The acute test could be used as a substitute for the chronic dietary method.