Omland Torbjørn, Hagve Tor-Arne
Akershus University Hospital, Lørenskog, Norway.
Heart Fail Clin. 2009 Oct;5(4):471-87. doi: 10.1016/j.hfc.2009.04.005.
Natriuretic peptides play a central role in cardiovascular, endocrine, and renal homeostasis and can be considered physiologic antagonists to the renin-angiotensin-aldosterone system. ANP and BNP in the circulation are derived primarily from the myocardium, whereas CNP is mainly derived from endothelial cells and the central nervous system. Increased ventricular and atrial diastolic wall stretch augment synthesis and release of BNP and NT-proBNP from cardiomyocytes, and is the principal stimulus controlling BNP production. Circulating BNP and NT-proBNP levels are increased in heart failure in proportion to disease severity, but elevated levels may also be observed in other cardiac and noncardiac disease states, including cardiac arrhythmias, ventricular hypertrophy, myocardial ischemia, pulmonary embolism, acute and chronic cor pulmonale, renal failure, anemia, hyperthyroidism, and sepsis. Fully automated analyses of both BNP and NT-proBNP can be rapidly performed on large hospital-based platforms as well as on small point-of-care devices.
利钠肽在心血管、内分泌和肾脏稳态中发挥核心作用，可被视为肾素-血管紧张素-醛固酮系统的生理拮抗剂。循环中的心房钠尿肽（ANP）和脑钠肽（BNP）主要来源于心肌，而C型钠尿肽（CNP）主要来源于内皮细胞和中枢神经系统。心室和心房舒张期壁张力增加会增强心肌细胞中BNP和N末端B型利钠肽原（NT-proBNP）的合成与释放，这是控制BNP产生的主要刺激因素。在心力衰竭时，循环中的BNP和NT-proBNP水平会随着疾病严重程度成比例升高，但在其他心脏和非心脏疾病状态下也可能出现升高，包括心律失常、心室肥厚、心肌缺血、肺栓塞、急慢性肺源性心脏病、肾衰竭、贫血、甲状腺功能亢进和脓毒症。BNP和NT-proBNP的全自动分析既可以在大型医院平台上快速进行，也可以在小型即时检测设备上进行。
