Brockhoff C, Warnholtz A, Münzel T
Abteilung für Kardiologie, Universitätskrankenhaus Eppendorf, Hamburg.
Ther Umsch. 2000 May;57(5):305-12. doi: 10.1024/0040-5930.57.5.305.
The natriuretic family consists out of three molecules that share significant amino acid sequence homologies and a looped motif. Atrial natriuretic peptide (ANP) and brain natriuretic peptide (BNP) are similar in their abilities to promote natriuresis and diuresis, to inhibit the renin-angiotensin-aldosteroneaxis and to act as vasodilators. The understanding concerning the actions of the C-type natriuretic peptide is incomplete, but this new family member acts as a vasodilator. Plasma levels of ANP and BNP are elevated in patients with unstable angina, acute myocardial infarction, and with congestive heart failure. BNP may be superior to ANP as a prognosticator for risk stratification after myocardial infarction and is independent of left ventricular ejection fraction. ANP and BNP have little therapeutic potential while experimental work as well as clinical trials suggest that the inhibition of the catabolism of natriuretic peptides in particular in combination with ACE-inhibitors may be clinically beneficial.
利钠肽家族由三种分子组成，它们具有显著的氨基酸序列同源性和环状基序。心房利钠肽（ANP）和脑利钠肽（BNP）在促进尿钠排泄和利尿、抑制肾素-血管紧张素-醛固酮系统以及作为血管扩张剂的能力方面相似。关于C型利钠肽作用的认识尚不完整，但这个新的家族成员可作为血管扩张剂。不稳定型心绞痛、急性心肌梗死和充血性心力衰竭患者的ANP和BNP血浆水平升高。作为心肌梗死后风险分层的预后指标，BNP可能优于ANP，且与左心室射血分数无关。ANP和BNP的治疗潜力不大，而实验研究以及临床试验表明，抑制利钠肽的分解代谢，特别是与血管紧张素转换酶抑制剂联合使用，可能具有临床益处。
