慢性心房颤动患者血清ANP和BNP水平的变化

目的:研究慢性心房颤动(CAF)患者血清心房利钠肽(ANP)、脑利钠肽(BNP)水平的变化及其临床意义。方法:放射免疫分析测定102例CAF患者、40例无CAF患者和30例对照组的血清ANP、BNP水平,并进行统计分析。结果:CAF组血清ANP和BNP水平均显著高于无CAF组和对照组(P均<0.01);无CAF组血清BNP显著高于对照组(P<0.01),但ANP与对照组无显著差异(P>0.05),CAF组中ANP与BNP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ANP、BNP水平依次显著性递增(P<0.01)。住院期间死亡组血清ANP和BNP水平也显著高于好转出院组(P<0.05,P<0.01)。结论:CAF患者血清ANP和BNP水平显著增高,并随心功能分级依次递增,死亡组更高。     

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。     

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。     

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。     

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。     

原发性高血压患者血浆corin水平与ANP、BNP及左室质量指数的相关性研究

目的观察分析原发性高血压(EH)患者的血浆Corin、心钠肽(ANP)和脑钠肽(BNP)水平以及左室质量指数(LVMI),探讨原发性高血压患者血浆Corin与ANP、BNP及左室质量指数的相关性。方法选取我院2015年1月至2016年1月收治的92例原发性高血压患者(观察组)和同期92例于我院体检正常者(对照组)作为研究对象,观察比较两组间观察期左心室是否肥厚患者间血浆Corin与ANP、BNP水平及左室质量指数。结果 (1)观察组患者血浆Corin、ANP和BNP水平及LVMI均明显高于对照组,观察组中左心室肥厚患者血浆Corin、ANP和BNP水平及LVMI又较无左心室肥厚患者高,且ANP和BNP水平及LVMI随着血浆Corin水平升高呈正相关上升趋势,比较组间差异均具有统计学意义(P0.05);(2)观察组中左心室肥厚患者LVDd、LVPWT、IVST、LVEF及LVMI均明显大于对照组,且LVPWT、IVST、LVEF及LVMI高于无左心室肥厚患者,组间比较差异具有统计学意义(P0.05)。结论原发性高血压患者其血浆Corin、ANP和BNP水平及LVMI均较正常人高,且ANP和BNP水平及LVMI随着血浆Corin水平的升高呈上升趋势,推测血浆Corin与ANP、BNP水平和LVMI之间呈正相关关系。     

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.     

原发性高血压患者心血管危险分层与血浆B型脑钠肽的关系

目的:探讨血浆B型脑钠肽(BNP)与原发性高血压患者心血管危险分层的关系及临床意义。方法:根据2005年中国高血压指南将131例原发性高血压患者分为低危、中危、高危和极高危四组,另选38名健康人组成对照组,采用微粒子酶免疫自动检测仪测定各组血浆BNP水平。结果:原发性高血压患者组BNP水平明显高于正常对照组(P0.01);低危至极高危组原发性高血压患者血浆BNP逐渐升高,各组间有显著性差异(P0.01);血浆BNP浓度水平与原发性高血压心血管危险分层呈显著正相关性(r=0.69,P0.01)。结论:BNP对原发性高血压患者的病情及预后评估具有重要临床意义。     

原发性高血压患者血清BNP和LPO水平关系的探讨

脑钠肽(BNP)是继心房肷后被发现在心血管疾病中起着重要作用的又一利钠肽系统成员[1].自由基和过氧化脂质(LPO)在疾病的发生和发展中起着十分重要的作用[2].本文报告原发性高血压患者血清BNP与LPO的关系,并就临床意义作初步探讨,现将结果报告如下.     

慢性CHF患者BNP与AT-Ⅱ及ALD水平的探讨

目的：探讨慢性充血性心力衰竭患者血中脑利钠肽（BNP）与血管紧张素-Ⅱ（AT-Ⅱ）及醛固酮（ALD）的水平,并进行相关性分析,以提示其在充血性心力衰竭（CHF）发展中的临床意义和价值。方法：使用美国博适公司生产的Triage Meter Plus型免疫荧光定量心衰快速检测仪,检测全血BNP水平。采用放射免疫分析（RIA）受试者血浆AT-Ⅱ、ALD含量。结果：CHF组BNP、AT-Ⅱ、ALD均显著高于对照组,且BNP与AT-Ⅱ、ALD水平呈正相关（P〈0.05）,治疗后血中水平均下降与治疗前差异有显著性（P〈0.01）。结论：同步监测BNP、AT-Ⅱ、ALD有助于早期发现CHF,判断病情及预后。     

利尿钠肽在诊断心力衰竭中的应用价值

探讨利尿钠肽的水平对心力衰竭（心衰）早期诊断的应用价值。采用放免法、ELISA法检测了129例心衰患者血浆中的心房利尿钠肽（ANP）、脑利尿钠肽（BNP）、N末端脑钠肽前体蛋白（NT-proBNP）水平,并与30例健康对照者进行了比较分析。结果显示,心衰患者血浆中的ANP、BNP、NT-proBNP显著高于健康对照组,且均随着NYHA分级的升高而逐渐增加,其含量在NYHA Ⅳ级时到达最高,心衰患者的血浆ANP、NT-proBNP水平与LVEF呈明显负相关。检测血浆中的ANP、BNP、NT-proBNP含量简便、快捷,可用于心衰诊断及NYHA分级判断。     

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.     

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。     

Expression and glucocorticoid regulation of natriuretic peptide clearance receptor (NPR-C) mRNA in rat brain and choroid plexus

The natriuretic peptide clearance receptor (NPR-C) binds atrial natriuretic peptide, brain natriuretic peptide and C-type natriuretic peptide with high affinity. This receptor lacks an intracellular guanylate cyclase domain, and is believed to exert biological actions by sequestration of released natriuretic peptides and/or inhibition of adenylate cyclase. The present report summarizes the first detailed mapping of NPR-C mRNA in rat brain. In situ hybridization analysis revealed high levels of NPR-C mRNA expression in frontal and retrosplenial granular cortices, medial preoptic nucleus, ventral cochlear nucleus and choroid plexus. NPR-C mRNA expression was also observed in deep layers of neocortex and limbic cortex, posterior cortical amygdala, ventral subiculum, amygdalohippocampal area, and dentate gyrus. Positive hybridization signal was observed in both anterior and intermediate lobes of the pituitary gland. Regulatory studies indicated that expression of NPR-C mRNA was increased in the medial preoptic nucleus of adrenalectomized rats, suggesting negative glucocorticoid regulation. No changes in NPR-C mRNA expression were observed in frontal cortex or choroid plexus. These results suggest a role for the NPR-C in modulation of natriuretic peptide availability and/or adenylate cyclase activity in a subset of central natriuretic peptide circuits concerned with cortical, olfactory and neuroendocrine functions. Response of the NPR-C gene to changes in circulating hormones suggests the capacity for glucocorticoid modulation of natriuretic peptide action at the receptor level.     

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.     

Characterization of the 5′-flanking region and chromosomal assignment of the human brain natriuretic peptide gene

Brain natriuretic peptide (BNP) is a cardiac hormone that occurs predominantly in the ventricle, and synthesis and secretion of BNP are greatly augmented in patients with congestive heart failure and in animal models of ventricular hypertrophy. In order to elucidate the molecular mechanisms underlying the human BNP gene expression in the heart, the human BNP gene was isolated from a size-selected genomic minilibrary. The 1.9-kb human BNP 5-flanking region (–1813 to +110) contained an array of putative cis-acting regulatory elements. Various lengths of the cloned 5-flanking sequences were linked upstream to the bacterial chloramphenicol acetyltransferase (CAT) gene, and their promoter activities were assayed. The 1.9-kb promoter region showed a high-level CAT activity in cultured neonatal rat ventricular cardiocytes. When the CT-rich sequences (–1288 to –1095) were deleted, the high-level activity was reduced to approximately 30%. The 399-bp BNP 5 flanking region (–289 to +110) showed approximately 10% activity of the 1.9-kb region. Furthermore, using human-rodent somatic hybrid cell lines, the BNP gene was assigned to human chromosome 1, on which the atrial natriuretic peptide gene is localized. The present study leads to a better understanding of the molecular mechanisms for the human BNP gene expression in the heart.Abbreviations ANP Atrial natriuretic peptide - AP-1 Activator protein-1 - BNP Brain natriuretic peptide - CAT Chloramphenicol acetyltransferase     

Development and application of a urodilatin (CDD/ANP-95#x2013;126)-specific radioimmunoassay

Urodilatin, a renal natriuretic peptide that is an analogue to circulating atrial natriuretic peptide [-ANP (99-126)], is measurable with a highly specific and sensitive radioimmunoassay. While most ANP antibodies cannot distinguish between urodilatin and other ANP analogues, the polyclonal urodilatin antibody specifically measures human urodilatin without any cross-reactivity to other ANP analogues. Urodilatin is not detected in blood from healthy volunteers nor from cardiac patients. Urinary urodilatin accounts for only a part of total urinary ANP immunoreactivity. Urodilatin excretion closely parallels sodium excretion in response to an acute volume load while changes in urinary immunoreactive ANP excretion do not reflect this renal response. We conclude that specific urodilatin assays are required to explore further the physiological role of the renal natriuretic peptide.     

N-terminal pro-brain natriuretic peptide for detection of cardiovascular stress in patients with obstructive sleep apnea syndrome

Patients with obstructive sleep apnea syndrome (OSAS) have an elevated incidence of cardiovascular events that may be related to an increased ventricular load and hypoxemia caused by apneas and hypopneas. N-terminal pro-brain natriuretic peptide (NTproBNP) appears to be an excellent marker of myocardial stretch and could serve as an indicator of subclinical cardiac stress, thereby identifying a patient population at risk for cardiac effects from OSAS. Adult patients presenting with suspected OSAS and scheduled for nocturnal polysomnography were recruited. Patients with heart or renal failure or severe lung disease were excluded. NTproBNP was measured the evening before and the morning after sleep. Blood pressure (BP) was monitored intermittently throughout the night. Fifteen male and 15 female subjects with a mean +/- SD body mass index of 38.2 +/- 9.8 were studied. Mean Apnea-Hypopnea Index (AHI) was 38.4 +/- 26, with 17 subjects having severe OSAS (AHI > 30). No subject had a significant rise in BP. NTproBNP values overnight decreased in 19 patients and rose in 11 (mean change 3.8 +/- 33 pg mL(-1)), but only one patient had an abnormal morning value. Three patients had an abnormal NTproBNP value prior to sleep, but their levels decreased with sleep. No correlations were detected between the evening baseline or postsleep NTproBNP levels and OSAS. Monitoring pre- and postsleep NTproBNP levels revealed no association with the occurrence or degree of OSAS, making it unlikely that NTproBNP could serve as a marker of cardiac stress in OSAS patients with stable BP and without overt heart failure.     

Atrial natriuretic peptide response to endurance physical training in the rat

Summary The effect of an endurance physical training programme on the plasma and atrial natriuretic peptides (ANP) and on renal glomerular ANP receptors was evaluated in male normotensive Wistar rats. Maximal O₂ uptake was significantly greater in the endurance trained (117.1 Ml O₂ · kg^–1 · min^–1, SEM 6.18 versus the control rats 84.2 ml O₂ · kg^–1 · min^–1, SEM 4.88, P<0.01. In addition, various muscle oxidative enzymes were also significantly higher in endurance trained animals. An increase in resting plasma [ANP] was observed after 11 weeks of physical training (40.02 pg · ml^–1, SEM 7.07 vs 22.8 pg.ml^–1, SEM 3.83, P<0.05). Glomerular ANP receptor density was lower in trained rats (272 fmol · mg^–1 protein, SEM 3.1 vs 380 fmol · mg^–1 protein, SEM 6.1, P < 0.05), whereas atrial tissue [ANP] was not significantly different between controls and trained animals. However, in trained rats, circulating [ANP] was closely correlated with left atrial [ANP] (r = –0.92, P<0.05). Resting systolic blood pressure had not changed at the end of this physical training programme. It is considered that under physiological conditions ANP may be involved in long-term extracellular fluid volume homeostasis through the regulation of renal glomerular ANP receptors, and that the left atrium might play a significant role in this long term fluid volume control.