Alarabi A A, Hansell P, Wikström B, Danielson B G
Department of Internal Medicine, University Hospital, Uppsala, Sweden.
Scand J Urol Nephrol. 1991;25(1):65-9. doi: 10.3109/00365599109024531.
Plasma concentrations of immunoreactive alpha ANF were measured before, during, and after 3 hours of hemodialysis (HD) and hemofiltration (HF). In seven healthy subjects plasma alpha ANF concentrations were measured to serve as controls. Highly elevated pre-treatment alpha ANF levels were obtained in the HD group (286 +/- 52 pg/ml, mean +/- SE), and in the HF group (275 +/- 48 pg/ml) as compared with the controls (40 +/- 3 pg/ml). The effect of both HD and HF on the alpha ANF concentration was not significant after the first hour of treatment. However, a significant decrease was obtained after the second (HD = 244 +/- 49, HF = 140 +/- 17) and third hours (HD = 244 +/- 48, HF = 135 +/- 15) (p less than 0.05) in both treatments. A steeper decline in the alpha ANF concentration was notable during HF compared with HD. There was a significant difference (p less than 0.05) when both modalities were compared at the end of treatment. A correlation (r2 = 0.98, p less than 0.001) was noted between changes in the alpha ANF levels and the ultrafiltration (UF) volumes only during HF. Plasma alpha ANF concentrations at the filter outlet were lower than at the inlet in both groups. It is concluded that the plasma alpha ANF concentrations are highly elevated in chronic renal failure patients. Despite the decrease in these concentrations during HD and HF it did not reach the normal plasma level. Monitoring of plasma alpha ANF may be a useful indicator for the extracellular volume status during HD and HF treatments.
在血液透析（HD）和血液滤过（HF）3小时的过程中及前后，测量了免疫反应性α心钠素（ANF）的血浆浓度。测量了7名健康受试者的血浆α ANF浓度作为对照。与对照组（40±3 pg/ml）相比，HD组（286±52 pg/ml，平均值±标准误）和HF组（275±48 pg/ml）的治疗前α ANF水平显著升高。治疗1小时后，HD和HF对α ANF浓度的影响均不显著。然而，在两种治疗的第2小时（HD = 244±49，HF = 140±17）和第3小时（HD = 244±48，HF = 135±15）后，均出现了显著下降（p＜0.05）。与HD相比，HF期间α ANF浓度下降更为明显。在治疗结束时比较两种方式时，存在显著差异（p＜0.05）。仅在HF期间，α ANF水平的变化与超滤（UF）量之间存在相关性（r2 = 0.98，p＜0.001）。两组滤器出口处的血浆α ANF浓度均低于入口处。结论是，慢性肾衰竭患者的血浆α ANF浓度显著升高。尽管在HD和HF期间这些浓度有所下降，但未达到正常血浆水平。监测血浆α ANF可能是HD和HF治疗期间细胞外液容量状态的有用指标。
