充血性心力衰竭患者对α-人心房利钠肽的血流动力学、肾脏及激素反应。

Hemodynamic, renal, and hormonal responses to alpha-human atrial natriuretic peptide in patients with congestive heart failure.

作者信息

Saito H, Ogihara T, Nakamaru M, Hara H, Higaki J, Rakugi H, Tateyama H, Minamino T, Iinuma K, Kumahara Y

出版信息

Clin Pharmacol Ther. 1987 Aug;42(2):142-7. doi: 10.1038/clpt.1987.124.

DOI:10.1038/clpt.1987.124

Abstract

Hemodynamic, renal, and hormonal effects of intravenous bolus injection of 50 micrograms synthetic alpha-human atrial natriuretic peptide (alpha-hANP) were studied in eight patients with congestive heart failure. alpha-hANP caused significant reductions in mean blood pressure and systemic vascular resistance. These responses were sustained up to 90 minutes and not accompanied by reflex tachycardia. Cardiac index and stroke volume index increased significantly at 90 minutes and pulmonary capillary wedge pressure, pulmonary arterial pressure, and mean right atrial pressure remained unchanged. Urine volume, urinary sodium excretion, creatinine clearance, and fractional excretion of sodium increased significantly, but fractional excretion of potassium and phosphate did not change. Elevated plasma renin activity, plasma aldosterone, and norepinephrine were suppressed after the injection of alpha-hANP. The bolus injection of this peptide has moderately hypotensive, vasorelaxant, and natriuretic effects in patients with congestive heart failure.

摘要

对8例充血性心力衰竭患者静脉推注50微克合成的α-人心房利钠肽（α-hANP）后的血流动力学、肾脏及激素效应进行了研究。α-hANP使平均血压和全身血管阻力显著降低。这些反应可持续长达90分钟，且不伴有反射性心动过速。90分钟时心脏指数和每搏量指数显著增加，肺毛细血管楔压、肺动脉压及平均右心房压保持不变。尿量、尿钠排泄、肌酐清除率及钠排泄分数显著增加，但钾和磷的排泄分数未改变。注射α-hANP后，升高的血浆肾素活性、血浆醛固酮和去甲肾上腺素受到抑制。对充血性心力衰竭患者静脉推注该肽具有适度的降压、血管舒张和利钠作用。