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[年轻血压正常和高血压受试者中利钠肽循环水平与激肽释放酶尿排泄之间的相关性]

[Correlations between circulation levels of natriuretic atrial peptide and urinary excretion of kallikrein in young normotensive and hypertensive subjects].

作者信息

Ferri C, Cammarella I, Giarrizzo C, Bellini C, Astorre P, Di Zenzo P, Santucci A, Musca A, Balsano F

机构信息

Istituto di Clinica Medica I, Università degli Studi di Roma La Sapienza.

出版信息

Ann Ital Med Int. 1991 Apr-Jun;6(2):217-23.

PMID:1836137
Abstract

The relationships between atrial natriuretic peptide (ANP) and the renal sodium-modulating systems have not yet been completely examined. In particular, the relationships between ANP and the kinins system are almost unknown. We thus examined an extremely selected cohort of normotensive (n = 29, mean age 21 +/- 2 years) and hypertensive subjects (n = 51m mean age 21 +/- 2.9 years), both without hypertensive heredity. After 7 days under normal sodium intake (120 mEq of Na+/day), blood samples were taken in the morning on awaking, for radioimmunoassay of plasma levels of aldosterone, ANP and renin activity. Blood was again drawn after one active hour in orthostatism. We also evaluated urinary kallikrein excretion from urine collected over the previous 24 hours. Our results showed higher plasma levels of ANP in young hypertensives than in normotensives (statistical significance p less than 0.0025). Urinary excretion of kallikrein was markedly reduced (p less than 0.001) in the hypertensive group (0.46 +/- 0.3 U/24 h) compared to youths with normal blood pressure (0.79 +/- 0.24 U/24 h), in which a relationship between plasma ANP and urinary kallikrein was not evident; young hypertensives, on the other hand, showed an inverse correlation (r = -0.72; p less than 0.001). Finally, our investigation, aside from establishing the presence of high circulating ANP levels even at the initial phases of hypertension, points out a new possible means of feedback among sodium-modulating systems. The opposite relationship between ANP and urinary kallikrein excretion in young hypertensives could be attributed to reduced activity of the renal kinins system and a compensatory attempt on the part of ANP.

摘要

心房利钠肽(ANP)与肾脏钠调节系统之间的关系尚未得到全面研究。特别是,ANP与激肽系统之间的关系几乎无人知晓。因此,我们研究了一组经过严格挑选的血压正常者(n = 29,平均年龄21±2岁)和高血压患者(n = 51,平均年龄21±2.9岁),两组均无高血压遗传史。在正常钠摄入量(120 mEq的Na⁺/天)下7天后,于清晨醒来时采集血样,用于放射免疫测定血浆醛固酮、ANP和肾素活性水平。在直立位活动1小时后再次采血。我们还评估了前24小时收集尿液中的尿激肽释放酶排泄量。我们的结果显示,年轻高血压患者的血浆ANP水平高于血压正常者(统计学显著性p小于0.0025)。与血压正常的年轻人(0.79±0.24 U/24 h)相比,高血压组的尿激肽释放酶排泄量显著降低(p小于0.001)(0.46±0.3 U/24 h),在血压正常的年轻人中血浆ANP与尿激肽释放酶之间的关系不明显;另一方面,年轻高血压患者表现出负相关(r = -0.72;p小于0.001)。最后,我们的研究除了证实即使在高血压初期也存在高循环ANP水平外,还指出了钠调节系统之间一种新的可能的反馈方式。年轻高血压患者中ANP与尿激肽释放酶排泄量之间相反的关系可能归因于肾脏激肽系统活性降低以及ANP的一种代偿性尝试。

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