Richards A M
Department of Cardiology, Princess Margaret Hospital, Christchurch, New Zealand.
J Cardiovasc Pharmacol. 1989;13 Suppl 6:S69-74.
In initial studies of human atrial natriuretic factor (ANF) administered to man, 100 microns intravenous bolus doses infused in normal volunteers and patients with essential hypertension resulted in clear increases in urinary excretion of sodium (four- to sixfold), urine volume, calcium, magnesium, and phosphorous. In addition, in both groups an acute but short-lived fall in blood pressure and rise in heart rate was observed. In these studies and other high dose constant infusion experiments, the response of the renin-angiotension-aldosterone system and plasma catecholamines was varied, either remaining unchanged or showing stimulation when high doses of ANF caused acute and substantial falls in blood pressure. In contrast, constant low-dose infusions of ANF in both normal and hypertensive man (0.75-2 pmol/kg/min) have consistently shown clear suppression of plasma concentrations of renin, angiotensin II, and aldosterone by at least 50% of baseline values. Such "physiological" doses of ANF are not associated with sympathetic nervous system activation even though subtle but significant falls in blood pressure (particularly systolic) may occur.
在对人体注射心房利钠因子(ANF)的初步研究中,对正常志愿者和原发性高血压患者静脉推注100微克的剂量后,尿钠排泄量(增加四至六倍)、尿量、钙、镁和磷明显增加。此外,两组均观察到血压急性但短暂下降以及心率上升。在这些研究和其他高剂量持续输注实验中,肾素-血管紧张素-醛固酮系统和血浆儿茶酚胺的反应各不相同,当高剂量ANF导致血压急性大幅下降时,它们要么保持不变,要么受到刺激。相比之下,对正常人和高血压患者持续低剂量输注ANF(0.75 - 2皮摩尔/千克/分钟)始终显示,血浆肾素、血管紧张素II和醛固酮浓度至少比基线值降低50%。这种“生理”剂量的ANF与交感神经系统激活无关,尽管可能会出现轻微但显著的血压下降(尤其是收缩压)。