Villarreal D, Freeman R H
Department of Physiology, University of Missouri School of Medicine, Columbia 65212.
J Lab Clin Med. 1991 Dec;118(6):515-22.
Over the last three decades the role of the renin-aldosterone axis for the renal conservation of sodium has become well established. In the last several years information has accumulated to indicate that ANF is an important complementary hormonal system involved in the elimination of sodium surfeit. Evidence has been presented to suggest that ANF and the renin-aldosterone axis function in an integrated manner for the regulation of sodium balance, with their primary actions exerted in the postprandial and postabsorptive phases, respectively. It is interesting that this hormonal integration continues to be operational during the compensated stage of experimental heart failure but at the expense of a higher level of activity of the ANF system. The significance of ANF as a compensatory mechanism in chronic heart failure remains to be fully elucidated, although the available longitudinal data in experimental animal models suggest that the role of ANF in the maintenance of sodium balance should be most apparent during the early and mild stages of heart failure, before a marked reduction in cardiac performance leads to an excessive activation of the renin-aldosterone axis that in turn can effectively override the natriuretic actions of ANF.
在过去三十年中，肾素 - 醛固酮轴在肾脏保钠方面的作用已得到充分确立。在过去几年里，越来越多的信息表明，心房利钠因子（ANF）是参与消除钠过剩的一个重要的互补性激素系统。已有证据表明，ANF和肾素 - 醛固酮轴以整合的方式发挥作用来调节钠平衡，它们的主要作用分别在餐后和吸收后阶段发挥。有趣的是，在实验性心力衰竭的代偿期，这种激素整合仍在起作用，但代价是ANF系统的活性水平更高。尽管实验动物模型中的现有纵向数据表明，在心力衰竭的早期和轻度阶段，在心脏功能显著下降导致肾素 - 醛固酮轴过度激活进而有效抵消ANF的利钠作用之前，ANF在维持钠平衡中的作用应该最为明显，但ANF作为慢性心力衰竭代偿机制的意义仍有待充分阐明。
