Heim J M, Gottmann K, Weil J, Haufe M C, Gerzer R
Medizinische Klinik Innenstadt, Universität München.
Z Kardiol. 1988;77 Suppl 2:41-6.
The action of ANF is, at least in part, mediated by the activation of particulate guanylate cyclase. Increases in plasma ANF levels induce a marked increase in the plasma levels and urinary excretion of cyclic GMP. In contrast to agents that stimulate particulate guanylate cyclase, activators of soluble guanylate cyclase, such as the bioactive molsidomine metabolite, SIN 1, induce only a modest, not significant, increase in plasma cyclic GMP levels. Thus, increases in plasma cyclic GMP levels appear to be specific for the activation of particulate guanylate cyclase. Cyclic GMP is stable in whole blood in the presence of EDTA and can easily be measured in plasma and urine. It may therefore be a valuable alternative for ANF measurement in the clinical routine. In contrast to urinary ANF excretion, the urinary excretion of cyclic GMP sensitively reflects increases in plasma ANF levels. Measurement of cyclic GMP excretion may therefore be an alternative for plasma ANF and plasma cyclic GMP measurement especially in situations where blood drawing is difficult, e.g. in newborns. Measurement of basal cyclic GMP followed by determination of increases in cyclic GMP levels after injection of a small ANF bolus dose tests the cellular sensitivity to ANF. This may give further insight in the mechanism of the regulation of ANF effects. Therefore, cyclic GMP in many cases appears to be a sensitive marker for the action of ANF in man.
心钠素（ANF）的作用至少部分是由颗粒性鸟苷酸环化酶的激活介导的。血浆心钠素水平的升高会导致血浆中环磷酸鸟苷（cGMP）水平和尿排泄量显著增加。与刺激颗粒性鸟苷酸环化酶的药物不同，可溶性鸟苷酸环化酶的激活剂，如生物活性的吗多明代谢产物SIN 1，只会使血浆cGMP水平有适度的、不显著的升高。因此，血浆cGMP水平的升高似乎是颗粒性鸟苷酸环化酶激活所特有的。在乙二胺四乙酸（EDTA）存在的情况下，cGMP在全血中是稳定的，并且可以很容易地在血浆和尿液中进行测量。因此，它可能是临床常规中心钠素测量的一种有价值的替代方法。与尿中心钠素排泄不同，尿中cGMP的排泄能敏感地反映血浆心钠素水平的升高。因此，尤其是在采血困难的情况下，如新生儿，测量cGMP排泄量可能是血浆心钠素和血浆cGMP测量的一种替代方法。测量基础cGMP，然后在注射小剂量心钠素推注后测定cGMP水平的升高，可测试细胞对心钠素的敏感性。这可能会进一步深入了解心钠素作用的调节机制。因此，在许多情况下，cGMP似乎是心钠素在人体中作用的一个敏感标志物。
