Zhang Z F, Shi X Y, Zhao Y T
Zhonghua Nei Ke Za Zhi. 1989 Nov;28(11):654-6, 700.
Changes of plasma atrial natriuretic factor (ANF) levels in 89 patients with different kinds of renal diseases (including 39 patients treated with hemodialysis) were studied. The results showed: 1. The mean value of plasma ANF level was significantly increased in patients with renal diseases than that in healthy subjects. The increase was positively correlated with the change of creatinine, serum potassium, mean arterial pressure and ptfV1. The plasma ANF level was markedly decreased after hemodialysis. 2. The right atrial pressure of 8 patients with chronic renal failure measured by right heart catheterization was normal. No significant changes occurred after hemodialysis. 3. Impedance cardiogram and mechanical cardiogram showed that left heart function was significantly improved after hemodialysis. 4. ANF was detected in ultrafiltration liquid. 5. There was no difference of the ANF content between the serum of the first and maintenance hemodialysis. The authors thought that the main causes of increase of plasma ANF level are decrease of catabolic metabolism in renal failure, stimulation of ANF secretion by left heart failure and increased loading of left atrium and increased production of ANF by body compensation as the result of mean arterial pressure increase. The decrease of ANF after hemodialysis was mainly due to improvement of renal and cardiac function, lessening of the left atrial loading, the reduced mean arterial pressure and its direct elimination by hemodialysis.
研究了89例不同类型肾病患者（包括39例接受血液透析治疗的患者）血浆心钠素（ANF）水平的变化。结果显示：1. 肾病患者血浆ANF水平的平均值显著高于健康受试者。其升高与肌酐、血钾、平均动脉压和ptfV1的变化呈正相关。血液透析后血浆ANF水平明显降低。2. 8例慢性肾衰竭患者经右心导管检查测得的右心房压力正常。血液透析后无明显变化。3. 阻抗心动图和机械心动图显示血液透析后左心功能明显改善。4. 在超滤液中检测到ANF。5. 首次血液透析和维持性血液透析患者血清中的ANF含量无差异。作者认为，血浆ANF水平升高的主要原因是肾衰竭时分解代谢降低、左心衰竭刺激ANF分泌、左心房负荷增加以及由于平均动脉压升高机体代偿性ANF产生增加。血液透析后ANF降低主要是由于肾和心功能改善、左心房负荷减轻、平均动脉压降低以及血液透析直接清除所致。
