非心源性水肿患者血浆心钠素浓度的变化

笔者应用灵敏度高、特异性强的放射免疫分析法,观测了30例非心源性水肿患者血浆心钠素浓度的变化,以探讨心钠素与非心源性水肿的关系。一、观察对象1.非心源性水肿组:30例中男16例,女14例,年龄17～67岁,平均44岁;病因分类:肝硬化腹水16例(男9例,女7例);     

晚期血吸虫病患者血浆心钠素检测的意义及与中医辩证分型…

本文应用放射免疫分析法检测３３例晚期血吸虫病患者血浆心钠素含量。结果晚期血吸虫病患者中，巨脾型患者血浆心钠素含量显著高于腹水型及健康人。单纯血瘀气滞型患者血浆心钠素含量显著高于血瘀气滞偏阳虚型和血瘀气滞偏阴虚型。表明：心钠素在晚期血吸虫病患者水，钠代谢中起一定作用，血浆心钠素含量与晚期血吸虫病中医辩证分型有一定关系。     

晚期血吸虫病患者血浆心钠素检测的意义及与中医辨证分型的关系

本文应用放射免疫分析法检测33例晚期血吸虫病患者血浆心钠素含量。结果晚期血吸虫病患者中,巨脾型患者血浆心钠素含量显著高于腹水型及健康人。单纯血瘀气滞型患者血浆心钠素含量显著高于血瘀气滞偏阳虚型和血瘀气滞偏阴虚型。表明:心钠素在晚期血吸虫病患者水,钠代谢中起一定作用。血浆心钠素含量与晚期血吸虫病中医辨证分型有一定关系。     

肺癌患者血浆心钠素测定的临床意义

肺癌患者血浆心钠素测定的临床意义高建飞，潘显光，刘志遐，李清泉，骆红星我们用放射免疫吸附法检测７５例肺癌患者血浆心钠素（ＡＮＰ），比较２０例肺癌患者治疗前后ＡＮＰ变化，并探讨其临床意义。７５例肺癌（Ｉ组）均经病理和／或细胞学证实，年龄５３．４２±１２...     

肺心病患者血浆心钠素水平临床分析

近年来．心钠素与呼吸系统疾病关系，颇受人们注意。本观察了肺心病患血浆心钠素水平的变化．现将结果报告如下。     

糖耐量减退者及糖尿病患者糖负荷后血浆心钠素水平的变化

我们观察了正常人、糖耐量减退(IGT)者及非胰岛素依赖型糖尿病(NIDDM)患者空腹及糖负荷后血浆心钠素(ANF)水平,探讨了ANF在糖尿病变化的机制及临床意义。     

无症状性心肌缺血患者血浆心钠素的测定

研究证明，心钠素（AtrialNatriureticFactorANF）是一种由心脏（主要是心房）分泌的循环激素，具有强大的利尿、利钠、扩张血管、降低血压和调节肾素一血管紧张素一醛固酮系统的作用，因而引起广泛关注。无症状性心肌缺血患者（SMI）血浆ANF浓度变化尚未见报道。我们应用放射免疫方法对60例SMI患者血浆ANF进行测定，对其临床意义作初步探讨。资料与方法1．试验组缺血性ST段的诊断标准：ST段水平型或下垂型压低≥1mm（J点后80ms）、持续时间≥1分钟、两阵缺血发作间歇≥1分钟。在记录生活日记时，缺血性ST段改变同时不伴有心绞痛…     

Plasma concentration of atrial natriuretic polypeptide in patients with atrial tachycardia

To investigate the mechanisms of polyuria associated with tachycardia, we measured plasma concentrations of alpha-human atrial natriuretic polypeptide (alpha-hANP) and cGMP in 6 patients with paroxysmal tachycardia. Plasma concentrations of immunoreactive alpha-hANP and cGMP increased by +69% (p less than 0.05) and +100% (p less than 0.05), respectively, during both paroxysmal atrial tachycardia and atrial fibrillation. To examine whether tachycardia per se raises the secretion of alpha-hANP, we also determined plasma concentrations of alpha-hANP and cGMP in 5 patients during rapid atrial pacing. The pacing-induced tachycardia also increased both of the plasma concentrations. Further, the examinations of cardiac and renal functions in patients with complete atrioventricular block during rapid pacing revealed that each of the increases in atrial pressures, urinary sodium excretion and creatinine clearance were in parallel with the change in plasma concentration of alpha-hANP. These results suggest that an increase in plasma concentration of alpha-hANP during paroxysmal tachycardia is mainly due to elevation of atrial pressure and that this increase in alpha-hANP contributes to tachycardia polyuria.     

慢性心力衰竭患者心钠素水平及与心功能关系的观察

目的探讨心钠素(ANP)在慢性心力衰竭发生与发展过程中的意义及与心功能的关系。方法选择35例慢性心力衰竭患者和32例正常对照,采用放射免疫法测定其血浆ANP水平,应用彩色多普勒超声心动图测定左心室收缩末期内径(LVSd)、左心室舒张末期内径(LNDd)、左心室射血分数(LVEF)、左心室短轴缩短率(LVFS)及心动周期中二尖瓣舒张晚期心室充盈峰速度(A)与二尖瓣舒张早期心室充盈峰速度(E)的比值(A／E),观察ANP水平与心功能之间的关系。结果心力衰竭患者血浆ANP水平比健康对照组明显升高(P<0．001),且随着心功能程度的不断加重,ANP水平逐渐升高．依次为心功能Ⅱ级<心功能Ⅲ级<心功能Ⅳ级(P<0．05-0．001)。ANP水平与LVEF、LVFS呈负相关,r值分别为0．76(P<0．01)、-0．72(P<0．01);与LVSd、LVDd及A／E呈正相关,r值分别为0．65(P<0．01)、0．79(P<0．01)、0．72(P<0．01)。结论慢性心力衰竭进展中,ANP水平与心力衰竭的严重程度密切相关,能够反映不同的心功能状态,为慢性心力衰竭的诊断与治疗提供参考依据。     

Influence of plasma alpha-human atrial natriuretic polypeptide on natriuretic and diuretic effects in patients with nephrotic syndrome

The physiological mechanism regulating secretion of alpha-human atrial natriuretic polypeptide (alpha hANP) was studied by measuring plasma alpha hANP (P alpha hANP) with radioimmunoassay during water immersion (WI). Twelve healthy volunteers and sixteen patients with nephrotic syndrome were immersed in water for 4 hours. During WI, alpha hANP level and urinary cGMP excretion (UcGV) increased significantly both in volunteers and patients, the urinary volume (UV) and urinary Na excretion (UNaV) also increased significantly. The mean peak values of alpha hANP and UcGV in volunteers were significantly lower than those in the patients, whereas the mean values of UV and UNaV in the former were significantly higher than those in the latter. The increase in alpha hANP level in volunteers correlated positively with the increase of UNaV, UV and UcGV during WI. The close correlations between the increased alpha hANP level and the increased UNaV, UV and UcGV was shown in the patients. These results suggest that alpha hANP is released into the circulation by acute central hypervolemia and plays a physiologically important role in maintaining water and electrolytes homeostasis in normal subjects and that the increased alpha hANP level in nephrotic syndrome makes compensatory regulation in water and electrolytes disorders.     

Clinical application of atrial natriuretic polypeptide in patients with congestive heart failure: beneficial effects on left ventricular function

Synthetic alpha-human atrial natriuretic polypeptide was infused in patients with congestive heart failure (CHF) (New York Heart Association class III or IV) and in those without CHF. The infusion of atrial natriuretic polypeptide (ANP) at a rate of 0.1 microgram/kg/min significantly decreased pulmonary capillary wedge pressure and increased stroke volume index in all of the patients with CHF, whereas it decreased pulmonary capillary wedge pressure but caused no significant change in stroke volume index in the patients without CHF. Concomitant significant reductions in total systemic resistance were observed in both groups of patients. The ANP infusion significantly increased the urine volume, the excretion of sodium, and endogenous creatinine clearance in the patients without CHF. In the patients with CHF, it also showed a tendency to increase all these variables, but the urine volume did not correlate with the reduction in pulmonary capillary wedge pressure. The ANP infusion also decreased plasma aldosterone concentrations in these patients, although no significant difference was observed in the decrement of the plasma aldosterone concentration in the patients with and those without CHF. These findings indicate that the ANP infusion improves left ventricular function in patients with CHF, and suggest that this improvement results mainly from the vasodilating activity of ANP.     

Atrium as a source of brain natriuretic polypeptide in patients with atrial fibrillation

BACKGROUND: Plasma brain natriuretic polypeptide (BNP) levels have been used as biochemical markers of systolic left ventricular (LV) dysfunction. Although in vitro studies have shown the existence of BNP messenger RNA in the atria, the main production site of BNP is believed to be the ventricle. The hypothesis that the atrium could be a source of BNP was examined in patients with lone atrial fibrillation (AF), the most common type of sustained arrhythmia. METHODS AND RESULTS: We studied 16 controls and 21 patients with lone AF. Plasma samples for BNP were selectively and serially obtained from the aorta, anterior interventricular vein (AIV), and coronary sinus (CS). Atrial natriuretic polypeptide (ANP) levels were also measured to determine whether the CS samples contained significant amounts of atrial venous drainage. Of the 3 sample locations, the CS had the greatest ANP levels, confirming transcatheter sampling position accuracy. BNP levels were significantly greater in the CS than AIV in the patients with AF (279 +/- 226 v 126 +/- 97 pg/mL; P < .01). Consequently, plasma BNP levels were also greater in the patients with AF than controls (103 +/- 90 v 5 +/- 2 pg/mL; P < .001). LV ejection fraction was significantly less in patients with AF than control patients. Atrial production of BNP decreased significantly after successful DC cardioversion of AF in the 5 restudied patients (182 +/- 139 v 59 +/- 64 pg/mL; P < .05). CONCLUSION: The data suggest that AF is a condition in which BNP is produced in the atrium itself.     

Circulating atrial natriuretic polypeptide in essential hypertension

To investigate the significance of atrial natriuretic polypeptide (ANP) in essential hypertension, we measured plasma ANP concentrations in 43 subjects with essential hypertension uncomplicated by cardiac or renal failure, in 16 subjects with borderline hypertension, and in 17 normotensive control subjects. Plasma ANP levels were significantly higher in hypertensive subjects compared to borderline hypertensive subjects (p less than 0.05) and normotensive control subjects (p less than 0.05). Hypertensive subjects with left ventricular hypertrophy (LVH) had higher plasma ANP levels than the hypertensive group as a whole (p less than 0.05). A significant positive correlation was observed between mean blood pressure and plasma ANP level in the hypertensive group (n = 43, gamma = 0.77, p less than 0.01). Furthermore, plasma ANP level was decreased significantly after 4 weeks of effective antihypertensive therapy compared with the initial value (p less than 0.05). These results suggest that plasma ANP is frequently elevated in hypertensive subjects with markedly high blood pressure or LVH, and it can be reduced by effective therapy with antihypertensive drugs.     

Exaggerated secretion of atrial natriuretic polypeptide during dynamic exercise in patients with essential hypertension

The plasma concentration of atrial natriuretic polypeptide (ANP) was measured in nine patients with essential hypertension during two grades of exercise tests performed in the supine position on a bicycle ergometer. The plasma ANP concentration significantly increased from 97.0 +/- 19.2 pg/ml to 107.6 +/- 23.7 pg/ml (p less than 0.05) during low-grade exercise (50% of the maximal heart rate) and from 96.2 +/- 16.5 pg to 192.8 +/- 30.7 pg/ml (p less than 0.01) during high-grade exercise (75% of the maximal heart rate). During high-grade exercise plasma epinephrine and norepinephrine concentrations showed significant increases. The plasma ANP concentration was significantly correlated with systolic blood pressure (r = 0.51; p less than 0.05). Patients with essential hypertension showed greater absolute increases in the plasma ANP concentration and systolic blood pressure during exercise compared to normotensive subjects. These results suggest that exercise stimulates secretion of ANP in response to its intensity in patients with essential hypertension and that a greater rise in atrial pressure, resulting from a greater elevation of systolic blood pressure, may be involved in the exaggerated secretion of ANP in patients with essential hypertension.     

腹水型晚期血吸虫病人血浆内皮素与心钠素水平的观察

目的 探讨腹水型晚期血吸虫病人血浆中内皮素(ET)、心钠素(ANP)的浓度与腹水形成的关系。方法 采用放射免疫技术非平衡法,用γ一计数器直接测定住院的慢性和腹水型晚期血吸虫病人血浆ET和ANP的浓度。结果 腹水型晚期血吸虫病人血浆ET和ANP含量均明显高于慢性血吸虫病人(t=3.054 9、P相似文献   

Plasma concentrations of alpha-human atrial natriuretic polypeptide and cyclic GMP in patients with heart disease

Plasma concentrations of immunoreactive alpha-human atrial natriuretic polypeptide (i alpha-hANP) and cyclic guanosine monophosphate (cGMP) were measured in 70 patients with heart disease. Plasma concentrations of i alpha-hANP were directly related to the severity of heart disease (F = 29.61, p less than 0.001). Plasma concentrations of i alpha-hANP were well correlated with pulmonary capillary wedge pressure (PCWP; r = 0.64, p less than 0.001), mean pulmonary arterial pressure (PAP; r = 0.62, p less than 0.001), and mean right atrial pressure (RAP; r = 0.75, p less than 0.001). Plasma concentrations of cGMP were also directly related to the severity of heart disease (F = 13.61, p less than 0.001) and highly correlated with plasma concentrations of i alpha-hANP (r = 0.73, p less than 0.001). Plasma concentrations of cGMP were also closely correlated with PCWP (r = 0.69, p less than 0.001), mean PAP (r = 0.61, p less than 0.001), and mean RAP (r = 0.60, p less than 0.001). The i alpha-hANP concentrations of plasma samples obtained from the coronary sinus were approximately fourfold higher than those of samples obtained from the pulmonary artery, whereas cGMP concentrations were comparable in plasma samples obtained from either site. Elevation of cGMP concentrations following intravenous infusion of synthetic alpha-hANP was comparable in plasma samples obtained from the coronary sinus and the pulmonary artery. These findings suggest that elevated plasma concentrations of i alpha-hANP in cardiac patients result from an increase in the secretion of ANPs, which is probably accelerated by elevation of right or left atrial pressure, and that plasma concentrations of cGMP reflect circulating levels of alpha-hANP.