原发性高血压患者血清利钠肽水平的变化

目的:研究原发性高血压(EH)患者血清利钠肽(ANP,BNP,CNP)水平的变化,及其与高血压分期和靶 器官损害间的关系。方法:放射免疫分析测定112例EH患者和47例非高血压患者的血清利钠肽(ANP,BNP, CNP)水平,并进行对照统计分析。结果:EH组血清ANP,BNP,CNP水平均较对照组显著增高(P均<0.01),而 且与平均动脉压成显著正相关(P均<0.01),但与体重指数无相关性意义,男女组间无统计学差异。Ⅰ、Ⅱ、Ⅲ期组 间平均血清ANP,BNP,CNP水平依次显著性递增(P均<0.05),不同分期的EH患者之间血清ANP,BNP,CNP水 平均有明显差异(P均<0.05)。EH患者中伴心脑肾并发症组血清ANP,BNP,CNP水平显著高于无并发症组(P 均<0.01)。结论:EH患者血清ANP,BNP,CNP水平显著增高,且与平均动脉压、高血压分期及是否伴有并发症 相关,提示ANP,BNP,CNP变化与病情严重程度及高血压的靶器官损害相关并有助于预后判断。     

COPD患者血清ANP、BNP和CNP测定及其临床意义

目的：探讨慢性阻塞性肺疾病（COPD）患者血清心钠素（ANP）、脑钠肽（BNP）、C型钠尿肽（CNP）水平的变化及其临床意义。方法：采用放射免疫分析79例COPD患者和36例健康对照组血清ANP、BNP和CNP水平,并进行统计分析。结果：COPD组血清ANP、BNP和CNP水平显著地高于健康对照组（t=3.6841,P〈0.01;t=11.70,P〈0.01;t=2.177,P〈0.05）,但Ⅰ、Ⅱ、Ⅲ和Ⅳ级组间血清ANP、BNP和CNP水平方差检验无显著性意义（F=2.123、F=1.515、F=0.165,P均〉0.05）。相互间相关性分析揭示：ANP、BNP和CNP三者间均呈显著正相关（r=0.369,P〈0.01;r=0.354,P〈0.01;r=0.426,P〈0.01）。住院期间死亡的患者血清ANP、BNP和CNP水平显著地高于好转出院的患者（t=5.149,P〈0.01;t=4.875,P〈0.01;t=2.830,P〈0.01）。结论：COPD患者血清ANP、BNP和CNP显著升高,且与病人的稳定情况、肺动脉压力及预后相关。     

脑钠钛在原发性高血压患者中的变化及意义

目的 :探讨原发性高血压患者脑钠肽变化及其临床意义。方法 :用放射免疫分析 79例原发性高血压 (EH)患者和 4 9例非高血压患者的脑钠肽 (BNP)水平 ,并进行对照统计分析。结果 :EH组血清BNP水平显著高于对照组 (p <0 0 1 ) ,且与平均动脉压成显著正相关 (p <0 0 5 ) ,但与体重指数无相关性意义。Ⅰ、Ⅱ、Ⅲ期组间平均血清BNP水平依次显著性递增 (p <0 0 1 ) ,伴心脑血管并发症组显著高于无并发症组 (p <0 0 1 ) ,男女组间无统计学差异。结论 :EH患者血清BNP水平显著增高 ,且与平均动脉压、高血压分期及是否伴有并发症相关 ,提示BNP变化与病情严重程度相关。     

慢性房颤患者TXB2、6-K-PGF1α和PGE2的变化探讨

目的：研究慢性心房纤颤（CAF）患者血清血栓素B2（TXB2）、6-酮-前列腺素F1α（6-K-PGF1α）和前列腺素E2（PGE2）水平的变化及其临床意义。方法：放射免疫分析测定162例CAF患者、印例无CAF患者和40例对照组的血清TXB2、6-K-PGF1α和PGE2水平,并进行统计分析。结果：CAF组血清TXB2水平显著高于无CAF组和对照组（P均〈0．01）,6-K-PGF1α显著低于对照组（P〈0．01）,PGE2三组间无显著差异（P均〉0．05）,CAF组中TXB2与6-K-PGF1α成显著正相关（P〈0．01）。CAF患者中Ⅰ、Ⅱ、Ⅲ、Ⅳ级心功能组间平均血清TXB2和6-K-PGF1α水平均呈依次显著性递增（P均〈0．01）,PGE2无显著性改变（P〉0．05）;伴脑血栓组血清TXB2和6-K-PC-F1α水平均显著高于无脑血栓组（P均〈0．01）;住院死亡组血清TXB2水平显著高于好转出院组（P〈0．01）。结论：CAF患者血清TXB：水平显著增高,并随心功能分级依次递增,伴脑血栓组更高,死亡组TXB2也明显增高;CAF患者血清6-K-PGF1α水平明显降低;PGE2则无明显改变。     

EH患者血清利钠多肽及血栓素B_2水平的分析

目的：探讨原发性高血压（EH）患者血清ANP、BNP、CNP及TXB2水平的变化及其临床意义。方法：30例EH患者和正常人对照组分为2组;不同EH分期Ⅰ、Ⅱ、Ⅲ期分为3组,将测定结果进行统计分析。四项血清标志物均采用放射免疫分析。结果：EH患者组ANP、BNP、CNP及TXB2四项血清指标水平均较对照组升高非常显著（P均〈0.01）。Ⅰ期组EH患者血清ANP、CNP及TXB2三项血清标志物与对照组比较差异均无显著性（P均〉0.05）,而血清BNP则显著高于对照组（P〈0.05）;Ⅱ期组患者ANP水平显著高于Ⅰ期组和对照组（P〈0.05）,而BNP、CNP和TXB2三项血清标志物则非常显著高于Ⅰ期组和对照组（P均〈0.01）。Ⅲ期组结果显示,ANP、BNP、CNP和TXB2四项血清标志物均非常显著地高于Ⅱ期组、Ⅰ期组及对照组（P均〈0.01）,相关分析结果显示,患者ANP、BNP和CNP三项指标与自身的平均动脉压呈显著正相关（r=0.298,P〈0.01;r=0.409,P〈0.01;r=0.412,P〈0.01）。结论：本文四项血清指标水平显著升高,测定数据的变化与EH的发病及病情进展有关。     

老年冠心病患者血清GH、T和E2的变化探讨

目的:探讨老年冠心病患者血清生长激素(GH)、睾酮(T)和雌二醇(E2)水平的变化及其临床意义。方法:采用放射免疫分析测定了112例老年冠心病患者和40例健康对照组的血清GH、T和E2水平。结果:老年冠心病组血清GH和E2水平显著低于对照组(P<0.01,P<0.05),T与对照组无显著差异(P>0.05)。GH与E2水平呈显著的正相关(P<0.05),但两者与T均无相关性(P均>0.05)。Ⅰ、Ⅱ、Ⅲ和Ⅳ级心功能组患者血清GH、T、E2均依次显著递减(P<0.05,P<0.01,P<0.01)。伴急性心肌梗死组血清GH和E2水平显著低于无心肌梗死组(P均<0.01),但T却无显著差异(P>0.05)。住院死亡组血清GH、T、E2均显著低于好转出院组(P<0.05,P<0.01,P<0.01)。结论:EH组血清GH和E2水平显著降低,GH、T和E2均随心功能降低而依次显著递减,伴急性心肌梗死组GH和E2水平显著降低,死亡组血清GH、T、E2均显著降低。     

B型尿钠肽、肌钙蛋白I、同型半胱氨酸与急性肺栓塞的相关性分析

目的 探讨B型尿钠肽、肌钙蛋白I、同型半胱氨酸与急性肺栓塞的相关性.方法 选取2015年5月至2017年5月期间,我院收治的104例急性肺栓塞(APE)患者作为研究对象,选取同期健康体检者100例作为对照组.比较急性肺栓塞组与健康体检者以及大面积肺栓塞患者与非大面积肺栓塞患者、死亡与存活患者血清BNP、TnI及Hcy水平以及三项指标对急性肺栓塞的诊断价值.结果 急性肺栓塞组患者血清BNP、TnI及Hcy水平显著高于健康对照组(P<0.05).大面积肺栓塞患者血清BNP、TnI及Hcy水平显著高于非大面积肺栓塞患者(P<0.05).急性肺栓塞死亡患者血清BNP、TnI及Hcy水平显著高于存活者(P<0.05).血清BNP+TnI+Hcy联合检测的灵敏度(86.7%)、特异性(90.9%)及准确度(88.5%)明显高于任一项指标的检测(P<0.05).Pearson相关性分析表明,BNP、TnI及Hcy是急性肺栓塞患者发生临床不良事件的独立危险因素,血清BNP与TnI及Hcy呈正相关关系.结论 血清BNP、TnI及Hcy联合检测可反映急性肺栓塞的病情严重程度,可作为预后评估的有效指标.     

血清CA125水平在心力衰竭患者心功能分级中的应用价值

目的 探讨血清CA125(糖类抗原125)与BNP(B型脑利钠肽)水平在心力衰竭患者心功能分级中的变化及其临床意义.方法 收集118例我院2011年1月至2011年12月住院且诊断为心力衰竭患者数据进行回顾性统计学分析.结果 与健康对照组比较,NYHA Ⅱ(纽约心脏病协会心功能分级)、NYHA Ⅲ、NYHA ⅣV、心血管疾病无合并心力衰竭组四组血清CA125、BNP水平均显著高于健康对照组(P＜0.01),且血清CA125与BNP水平升高与NYHA分级呈正相关.不同病因(冠心病、风湿性心脏病、高血压性心脏病、扩张型心肌病、心脏瓣膜疾病)组血清CA125、BNP水平两两比较扩张型心肌病组血清CA125水平显著高于高血压性心脏病组(P＜0.05),而BNP水平在不同病因组中无统计学差异.左心室扩大组血清CA125水平显著高于正常左心室组(P＜0.01);而LVEF水平显著低于正常左心室组(P＜0.01).NYHA分级有胸腔积液、心包积液、房颤组血清CA125水平均高于无上述体征组,且差异具有统计学意义(P＜0.01).血清CA125与BNP呈显著正相关(P＜0.01);血清CA125与LVEF(左室射血分数)呈显著负相关(P＜0.01).结论 结合血清CA125、BNP、LVEF等指标可判断HF严重程度,并为NYHA分级提供实验室辅助依据.血清CA125、BNP、LVEF等指标作为临床实验室指标,综合病因、症状、体征和其他非创伤性指标可有效监控HF的发生与发展.     

2型糖尿病血管病变时血浆ANP、BNP及CNP的变化及临床意义

目的：探讨血浆心钠素(ANP)、脑利钠肽(BNP)、C型利钠肽(CNP)在2型糖尿病血管病变时的变化及其临床意义。方法:应用酶联免疫吸附法(ELISA)测定正常对照组(9例)、2型糖尿病无血管病变组(34例)及2型糖尿病血管病变组(23例)血浆proANP、BNP fragment及NT-proCNP浓度，分析各组间血浆利钠肽水平的变化及相关因素。结果:2型糖尿病血管病变组血浆ANP、BNP明显高于另外2组（P<0.01），而血浆CNP明显降低（P<0.01），2型糖尿病血管病变组各亚组(微血管病变组、大血管病变组及微血管合并大血管病变组)间血浆利钠肽水平无明显差异（P>0.05）。2型糖尿病血管病变组血浆ANP与BNP间存在显著正相关（r=0.309, P<0.05），ANP与CNP（r=-0.374, P<0.05）以及BNP与CNP（r=-0.653, P<0.01）间存在显著负相关。结论:血浆ANP、BNP及CNP的联合检测可以作为简便、价廉、可靠的糖尿病血管病变的筛选指标。     

慢性心力衰竭患者血清GH和IGFⅡ测定的意义

目的:探讨慢性心力衰竭患者血清生长激素(GH)和胰岛素样生长因子Ⅱ(IGFⅡ)变化及其临床意义。方法:用放射免疫分析测定了146例慢性心力衰竭(CHF)患者和50例非慢性心力衰竭患者的血清GH和IGFⅡ水平,并进行对照统计分析。结果:CHF组血清GH显著低于对照组(P<0.01),IGFⅡ水平显著高于对照组(P<0.01),两者间成显著负相关(r=-0.337,P<0.05)。在Ⅱ、Ⅲ、Ⅳ级组间,血清GH依次递减(FGH=40.88,P<0.01),IGFⅡ水平却依次递增(FIGFⅡ=3.208,P<0.05);GH水平在Ⅳ级组显著低于Ⅱ级组和Ⅲ级组(P<0.01),同时在Ⅲ级组显著低于Ⅱ级组(P<0.01);IGFⅡ水平在Ⅳ级组显著高于Ⅱ级组(P<0.05)。住院期间死亡组血清GH显著低于好转组(P<0.01),但IGFⅡ水平显著高于好转出院组(P<0.01)。结论:CHF患者血清GH显著降低,IGFⅡ显著升高,两者间成显著负相关。Ⅳ级组血清GH显著低于Ⅱ级组和Ⅲ级组,IGFⅡ则显著高于Ⅱ级组,住院期间死亡组血清GH显著降低,IGFⅡ水平显著升高。     

The nocturnal secretion of cardiac natriuretic peptides during obstructive sleep apnoea and its response to therapy with nasal continuous positive airway pressure

The nocturnal secretion profile of the newly identified natriuretic peptide (NP), brain natriuretic peptide (BNP), was studied in 14 patients with obstructive sleep apnoea syndrome (OSAS) (apnoea hypopnoea index: 60.5±3.4, mean±SE) during two separate nights before and during nasal continuous positive airway pressure (NCPAP) therapy. Plasma levels of NPs (atrial natriuretic peptides; ANP and BNP) were measured at 2-h intervals during sleep. Simultaneously, blood pressure was measured by a non-invasive method (Finapres^®, Ohmeda, Englewood, CO, USA) and urine was collected for determing volume and catecholamine levels. Urinary and serum sodium concentration were determined before and after the study. Eight non-snoring subjects were also studied for the investigation of normal nocturnal profiles of BNP levels. To understand the discrete secretion profiles of the two NPs during sleep, blood was sampled from an additional seven patients every 5 min over a 30-min period around 00.00 and 04.00 hours before NCPAP. In patients with OSAS, plasma BNP levels increased from the beginning of sleep (22:00 h) to the morning (06:00 h) before NCPAP therapy (P< 0.01, anova ). Baseline BNP levels were not significantly correlated with patient's clinical and poly- somnographic parameters. However, in the latter half of the sleep period (02:00–06:00 h), increases in BNP levels during the night before NCPAP therapy were significantly correlated with blood pressure elevations (systolic: r=0.784 P< 0.01, diastolic: r=0.587 P< 0.01) and with apnoea duration (r=0.582 P< 0.01). In normal subjects BP and BNP levels were not changed significantly during sleep. Plasma BNP levels were well correlated with concomitant ANP levels (P< 0.001). NCPAP therapy reduced ANP and BNP levels during sleep and in the morning (P< 0.01). Plasma levels of BNP at 5 min intervals before NCPAP therapy revealed few variations. On the other hand, ANP levels fluctuated over the 30-min period. Changes in BNP levels during sleep in the patients with OSAS may be related to blood pressure variations, but may be too small to play a significant physiological role in regulating diuresis in OSAS. Further work is required to determine the precise role of dual natriuretic system in cardiovascular load and natriuresis in OSAS.     

Localization of 125I-labelled α-r-atrial natriuretic peptide in rat tissues by whole-body and microautoradiography

¹²⁵I-labelled α rat atrial natriuretic peptide (28 amino acids: Ser 99–Tyr 126) ([¹²⁵I]α-rANP) was given i.v. to Sprague—Dawley rats and the distribution of radioactivity in the tissues was examined by whole-body and microautoradiography at intervals from 2 min to 4 h after the administration. Inhibition of uptake of the [¹²⁵I]α-rANP by simultaneous injection of an excess of non-labelled α-rANP was taken as an indication that highly labelled structures in rats injected with [¹²⁵I]α-rANP alone are due to an abundance of specific receptors for the peptide. In the rats given only the [¹²⁵I]α-rANP a rapid and high radioactivity occurred in the renal glomeruli, the endocardium of the heart ventricles, the endothelium of the processus ciliares of the eyes, the portal vessels and a few larger vessels of the liver, the subcapsular vessels of the adrenal glands and the parenchyma of the lungs. Other tissues showing a distinct, but less prominent, radioactivity were the endocardium of the heart atria, the walls of the great afferent and efferent vessels in the thoracic cavity, the choroid plexuses of the brain ventricles, the pia mater, brown fat, the muscularis layer of the stomach and the intestines, the lamina propria of the villi in the small intestine and the walls of a few small blood vessels in the kidney medulla. The specific labelling was highest at 2 min after injection and then diminished at later intervals. Several of the labelled structures are localized in tissues involved in the regulation of blood pressure, and fluid and electrolyte homeostasis, processes in which the atrial peptides are considered to play a role. It is suggested that high concentrations of receptors are present at the sites at which the [¹²⁵I]α-rANP was strongly localized and that biological effects of the atrial peptides are exerted via these structures.     

心房利钠利尿肽原不同肽段的生物学效应及其相互作用

心房利钠利尿肽原（pro-atrial natriuretic peptide,proANP）在蛋白水解酶corin的作用下分解为众多小分子片段,包括氨基端前体片段（NT-proANP）、长效利钠利尿肽（long-acting natriuretic peptide,LANP）、血管舒张肽（vessel dilator）、利钾利尿肽（kaliuretic peptide,KP）、尿舒血管素（urodilatin）和羧基端的心房利钠利尿肽（atrial natriuretic peptide, ANP）等。近年发现这些活性片段不仅各自具有相对独立的生物学效应,而且相互作用,形成复杂的调节网络,在机体稳态维持中具有重要的生理和病理生理意义。     

实时荧光定量PCR在检测人ANP基因表达的应用

目的建立心房钠尿肽（ANP）基因mRNA表达水平的实时荧光定量PCR检测方法,并对该方法进行初步评价。方法以基因表达产物为模板,建立实时荧光定量PCR检测方法,对样本中的心房钠尿肽含量进行相对定量,比较不同样本组的基因表达水平。结果所建立的实时荧光定量PCR方法熔解曲线中熔解峰单一。肺癌患者胸腔样本的ANP含量为对照样本的4.68倍,血清样本为对照样本的16.03倍。结论所建立的ANP实时荧光定量PCR检测方法具有较高的特异性。肺癌患者胸腔液和血清中ANP的含量明显增高。     

Detection of immunoreactive atrial and brain natriuretic peptides in the equine atrium

The distribution of immunoreactivity (IR) for cardiodilatin/atrial natriuretic peptide (CDD/ANP) and brain natriuretic peptide (BNP) was examined immunohistochemically and immuno-electron-microscopically in the equine atrium, using specific antibodies. In the immunohistochemical studies, IR-CDD/ANP and IR-pBNP-26 (porcine BNP-26 immunoreactivity) was detected in the cytoplasm of the auricular cardiocytes, but IR-hBNP-32 (human BNP-32 immunoreactivity) was not. The double immunogold labelling method for IR-hBNP-28 and IR-pBNP-26 revealed that gold particles of different sizes were located in the same secretory granules in the cardiocyte, but no gold particles for IR-hBNP-32 were detected. These results show that CDD/ANP and porcine BNP-like peptides are colocalized in the same secretory granules of the equine atrium. They suggest that the equine atrium secretes both CDD/ANP and BNP-like peptides.     

Effect of atrial natriuretic peptide AP II on morphology and function of the adrenal cortex in albino rats

Central Research Laboratory, Khabarovsk Medical Institute. (Presented by Academician of the Russian Academy of Medical Sciences Yu. A. Romanov.) Translated from Byulleten' Éksperimental'noi Biologii i Meditsiny, Vol. 114, No. 7, pp. 73–75, July, 1992.     

Plasma atrial natriuretic peptide (ANP) concentration and fluid balance during rapid intravenous saline infusions in camels

Human muscle samples were obtained with the percutaneous biopsy technique. The samples were membrane-hyperpermeabilized (skinned) using a chemical or freeze-drying technique. Short single fibre segments were dissected from the sample, transferred to an experimental chamber, connected to a force transducer and manipulator, and exposed to temperature-controlled solutions. The force generating-capacity, the sensitivity of the contractile apparatus to calcium and the caffeine threshold for calcium release from the sarcoplasmic reticulum could be studied in the short muscle fibre segments obtained from man with the percutaneous muscle biopsy technique. The average length of the fibre segments between the connectors was 0.44±0.21 mm. Thus, detailed studies of the contractile machinery can be made on human skinned muscle fibres with only minimal discomfort to the patient or subject during biopsy, which should be useful in studies of neuromuscular disease, muscle plasticity or in applied physiology.     

Central venous pressure – a physiological stimulus for secretion of atrial natriuretic peptide in humans?

A sensitive radio-immunoassay (RIA) for the measurement of human α-atrial natriuretic peptide (ANP) in extracted plasma was developed and used in a study of the possible effect of posture on the concentration of ANP in plasma. The least detectable quantity was less than 2 pg per tube equivalent to 5 pg ml^-1 plasma. In the middle sensitivity range (approximately 50 pg per tube), the within-assay and between-assay coefficients of variation were 4.0 and 2.8%, respectively. The recovery of ANP added to plasma prior to extraction was 95–101%. High pressure liquid chromatography (HPLC) of plasma extracts revealed that endogeneous ANP was eluted in the same fractions as synthetic ANP. In order to investigate the effect of posture on the concentration of ANP in plasma six healthy volunteers were exposed to five positions in the following sequence: supine, standing, sitting, supine and 10° head-down tilt on a tilt-table. The concentration of ANP was lower in the standing and sitting position than in the supine and head-down tilted position. In another study six healthy volunteers were subjected to passive tilting on a tilt-table in order to evaluate the effect of tilting on blood pressure (BP), heart rate, central venous pressure (CVP) and the concentration of ANP in plasma. It was found that a fall in CVP was accompanied by a significant decrease in the concentration of ANP and that a rise in CVP was accompanied by a rapid increase in the concentration of ANP in plasma. The results are in agreement with the hypothesis that CVP is a physiological stimulus for the secretion of ANP.