饱和巡回潜水时尿中ANP、ADH和某些电解质排泄量的变化

本工作观察了4名健康男性潜水员250m饱和潜水300m巡回潜水时的尿量和心房钠尿肽(atrial natriuretic polypeptide,ANP)、抗利尿激素(antidiuretic hormone,ADH)以及某些电解质排泄量的变化。结果显示在整个高气压暴露期间尿量显著增加,夜间更为明显。尿ANP排泄量从加压阶段即开始显著增加、尿APH排泄量除在加压阶段和高压停留的最初阶段显著增加外,均显著降低。因此,ANP对高压暴露最初阶段的多尿可能起决定性作用。尿量与尿ANP和尿ADH分别呈非常显著的正相关和非常显著的负相关。上述各项变化在减压至常压当天回到潜水前常压对照值水平。尿电解质排泄量除夜间尿Na~+、Cl~-、Ca2~(2+)和Mg~(2+)显著增加外,尿K~+和P(无机)几乎没有一致的统计学上的显著变化。在高压下长期暴露夜间尿Mg~(2+)排泄量显著增加,尚未见国内外有类似报道。

Urinary ANP, ADH and Electrolyte Excretion during Saturationexcursion Diving to Pressures Equivalent to 250 and 300m

Four male divers were exposed to a 26 and 31 ATA He-O_2 environment for 2 days. Urine was collected diurnally(0700-1900h) and nocturally (1900-0700h)before (predive 1 ATA air), during, and after(decompression and postdive 1ATA air) exposure to hyperbaria. Urine flow increased markedly and was mostly attributable to the urine flow during 1900-0700h. The secretion of atrial natriuretic polypeptide(ANP) increased solely at night during hyperbaria. On the other hand, the secretion of antidiuretic hormone(ADH) was suppressed but increased during compression and the early phase of hyperbaric exposure before it decreased. Linear regression analysis showed that urinary excretion of ANP was significantly correlated with urine flow(r=0.88, P<0.01) and that of ADH negatively correlated with it(r=0..61, P<0.01). Urinary excretion of Na~+, Cl~-, Ca~(2+)and Mg~(2+) significantly increased at night during hyperbaria while there was no Consistent change in the excretion of K~+and P. These results suggest that both stimulated ANP secretion and suppressed ADH secretion be corrdlative with the increase of urine and that nocturia be mostly attuibutable to stimulated ANP secretion. We observed that urinary excretion of ANP significantly increased as early as during the compression phase, which suggested that ANP plays a decisive role in the early diuresis.