体外反搏治疗冠心病前后血浆心钠素水平临床分析

血浆心钠素为心脏分泌的一种多肽激素,以右心耳含量最高。其利尿机制为:(1)增加肾小球滤过率;(2)增加肾血流量,影响逆流倍增机制;(3)使乳头部集合管钠重吸收降低;(4)抑制血管加压素的释放。体外反搏提高肾动脉灌注压,增加回心血量。提高右心房压力,使心房牵张力上升,中心静脉压增高,均可刺激心房肌细胞分泌和释放心钠素。本组病人体外反搏前血浆心钠素水平平均为2.8ng/ml,反搏后为3.4ng/ml,有显著统计学差异(t<2.703 P<0.05)。病人在体外反搏治疗后表现尿量增多,心功能明显改善。

THE CONCENTRATIONS OF ATRIAL NATRIURETIC FA CTOR IN BLOOD PLASMA OF PATIENTS WITH CORONARY HEART DISEASE BEFORE AND AFTER EXTERNAL COUNTERPULSATION

Atrial natriuretic factor(ANF) is a polypeptide hormone secreted by the cardiac muscular cells.The tissue of the right auricle has the highest content of ANF than others have.The diuretic mechanism of ANF contains:(1)increase of filtration rate in glomerulus,(2) increase of renal blood flow and change of countercurrent multipli- er effect,(3)reduction of resor- ption of collecting tubules in re- nal papillae for natrium and(4) inhibition to releasing vasopressin. External counterpulsation enables the atrial muscular cells to secrete ANF through growing arterirenal perfusion pressure,increasing re- turned blood volume,raising the pressure in the right atrium and central veins,and strenghthening atrial stretch tension.In our pat- ients,it is found that the average ANF levels in the plasma are 2.8ng/ml before counterpulsation and 3.4ng/ml after counterpulsa- tion respectively,with significant difference between the two levels (P<0.05)After treatment,the urine volumes of the patients were increased and the cardiac functions were obviously improved.