Toyoshima Katsuaki, Momma Kazuo, Imamura Shinichiro, Nakanishi Toshio
Section of Pediatric Cardiology, Tokyo Women's Medical University, Tokyo, Japan.
Neonatology. 2007;92(2):139-44. doi: 10.1159/000101526. Epub 2007 Apr 4.
Alpha-human atrial natriuretic peptide (hANP) reportedly increases in premature infants with patent ductus arteriosus (PDA).
To clarify a possible hANP effect to reopen the postnatal ductus, we studied in vivo reopening of the postnatal DA by a recombinant hANP, carperitide, in rats.
Near-term rat pups were incubated at 33 degrees C following caesarean section. The inner diameter of the ductus was measured with a microscope and a micrometer following rapid whole-body freezing. The DA constricted quickly after birth, and the inner diameter was 0.80 and 0.08 mm at 0 min (fetal state) and 60 min after birth. hANP concentration in the pup blood and the ductus-dilating effect of hANP were studied by subcutaneous injection of hANP at 60 min after birth, and by measurement 7, 15, 30 and 60 min later.
The peak hANP concentration was 790 pg/ml at 7 min with 1 mg/kg, which is similar to the level seen in preterm infants with symptomatic PDA. hANP dilated the postnatal ductus dose dependently and maximally at 7 min after injection. hANP dilated the postnatal constricted ductus completely to 0.79 mm in diameter with a large dose (10 mg/kg) and to 0.55 mm with 1 mg/kg.
hANP reopens the constricted postnatal DA dose dependently in rats. The increased hANP, accompanying premature PDA, may delay closure of the DA.
据报道,患有动脉导管未闭(PDA)的早产儿体内α-人心房利钠肽(hANP)水平会升高。
为了阐明hANP可能对产后动脉导管重新开放产生的影响,我们在大鼠体内研究了重组hANP卡培立肽对产后动脉导管的重新开放作用。
剖宫产术后将接近足月的大鼠幼崽置于33℃环境中。快速全身冷冻后,用显微镜和测微计测量动脉导管的内径。出生后动脉导管迅速收缩,出生后0分钟(胎儿状态)和60分钟时内径分别为0.80毫米和0.08毫米。在出生后60分钟皮下注射hANP,并在7、15、30和60分钟后进行测量,研究幼崽血液中hANP浓度以及hANP的导管扩张作用。
1毫克/千克剂量时,hANP浓度在7分钟时达到峰值790皮克/毫升,这与有症状PDA的早产儿体内水平相似。hANP注射后7分钟时对产后动脉导管的扩张作用呈剂量依赖性且达到最大程度。大剂量(10毫克/千克)hANP可使产后收缩的动脉导管完全扩张至直径0.79毫米,1毫克/千克剂量时可扩张至0.55毫米。
hANP在大鼠体内可使收缩的产后动脉导管剂量依赖性地重新开放。早产儿PDA时hANP升高可能会延迟动脉导管的闭合。