Wambach G, Schittenhelm U, Stimpel M, Bönner G, Kaufmann W
Department of Medicine II, University of Cologne, F.R.G.
J Cardiovasc Pharmacol. 1989 May;13(5):748-53.
We investigated the impact of angiotensin I-converting enzyme (ACE) inhibition by enalapril (3 X 2.5 mg p.o.) on the renal action of acute intravenous (i.v.) infusion of atrial natriuretic peptide (1-28-hANP 0.1 micrograms/kg/min for 30 min) in 10 normal subjects. During the control infusion of ANP, urinary sodium excretion rose from 4.5 +/- 0.8 to 11.2 +/- 2.2 mEq/min and urine volume from 32 +/- 14 to 115 +/- 34 ml/30 min. This increment in urinary volume and sodium output during ANP infusion was almost completely reduced by ACE inhibition. ANP plasma levels before and during the infusion and stimulation of urinary cGMP excretion were unaltered by ACE inhibition. However, enalapril treatment reduced systolic blood pressure (SBP) from 112 +/- 3 to 106 +/- 3 mm Hg and diastolic blood pressure (DBP) from 71 +/- 2 to 66 +/- 3 mm Hg. The small rise in glomerular filtration rate (GFR) during the control infusion of ANP was not observed after pretreatment with enalapril. The study demonstrates the importance of the renin-angiotensin system for the natriuretic and diuretic action of ANP in normal humans.
我们研究了依那普利（口服，3×2.5毫克）抑制血管紧张素I转换酶（ACE）对10名正常受试者静脉注射心房利钠肽（1-28-hANP，0.1微克/千克/分钟，持续30分钟）的肾脏作用的影响。在输注心房利钠肽的对照期间，尿钠排泄量从4.5±0.8毫当量/分钟增加到11.2±2.2毫当量/分钟，尿量从32±14毫升/30分钟增加到115±34毫升/30分钟。ACE抑制几乎完全降低了输注心房利钠肽期间尿量和钠排出量的增加。ACE抑制对输注期间和刺激尿中环鸟苷酸（cGMP）排泄时的心房利钠肽血浆水平没有影响。然而，依那普利治疗使收缩压（SBP）从112±3毫米汞柱降至106±3毫米汞柱，舒张压（DBP）从71±2毫米汞柱降至66±3毫米汞柱。用依那普利预处理后，未观察到输注心房利钠肽对照期间肾小球滤过率（GFR）的小幅升高。该研究证明了肾素-血管紧张素系统对正常人体内心房利钠肽的利钠和利尿作用的重要性。
