Petrillo A, Scherrer U, Gonvers J J, Nussberger J, Marder H, de Vane P, Waeber B, Hofstetter J R, Brunner H R
Policlinique Médicale Universitaire, C.H.U.V., Lausanne, Switzerland.
J Cardiovasc Pharmacol. 1988 Sep;12(3):279-85. doi: 10.1097/00005344-198809000-00004.
The effect of a synthetic atrial natriuretic peptide (h-ANP, 25 amino acids, Wy-47.663) on blood pressure, renal electrolyte excretion, plasma catecholamines, and plasma renin activity was studied in nine patients with cirrhosis of the liver and ascites. The peptide was infused intravenously at 24-h intervals for 2 h in groups of four patients each in two different doses (0.015 and 0.075 micrograms/kg/min or 0.06 and 0.3 micrograms/kg/min). A control experiment with the vehicle was performed in all patients. In three patients h-ANP (1 and 2 micrograms/kg i.v.) was administered as an intravenous bolus injection. Consistent falls in blood pressure were observed during h-ANP infusion only with the two higher doses. The two lower infused doses induced a consistent natriuresis; this renal response was abolished when the two larger doses were used. When given as a bolus, h-ANP had a natriuretic effect comparable to that of the two lower doses of infused h-ANP. Plasma catecholamines and plasma renin activity increased during infusion of the two higher doses of h-ANP. It thus appears that in patients with cirrhosis and ascites, the natriuretic effect of infused h-ANP decreases rather than increases when the doses are raised. Bolus administration of h-ANP may be less prone to trigger counterbalancing responses and side-effects.
研究了合成心房利钠肽（h-ANP，25个氨基酸，Wy-47.663）对9例肝硬化腹水患者的血压、肾电解质排泄、血浆儿茶酚胺和血浆肾素活性的影响。该肽以24小时间隔静脉输注2小时，每组4例患者，分为两种不同剂量（0.015和0.075微克/千克/分钟或0.06和0.3微克/千克/分钟）。所有患者均进行了溶剂对照实验。对3例患者静脉推注h-ANP（1和2微克/千克）。仅在输注两种较高剂量的h-ANP时观察到血压持续下降。两种较低的输注剂量引起持续的利钠作用；当使用两种较大剂量时，这种肾脏反应消失。静脉推注时，h-ANP的利钠作用与两种较低剂量的输注h-ANP相当。在输注两种较高剂量的h-ANP期间，血浆儿茶酚胺和血浆肾素活性增加。因此，在肝硬化腹水患者中，当剂量增加时，输注h-ANP的利钠作用似乎会降低而不是增加。静脉推注h-ANP可能较不易引发平衡反应和副作用。
