Yamaji T, Ishibashi M, Takaku F, Sato F, Kamoi K, Nakaoka H, Fujii J, Hasegawa K, Morii H
Jpn J Med. 1987 May;26(2):207-11. doi: 10.2169/internalmedicine1962.26.207.
In an attempt to clarify the clinical significance of atrial natriuretic peptide (ANP) in man, plasma levels of immunoreactive ANP were studied in patients with heart diseases and in those with chronic renal failure. When ANP concentrations in pulmonary arterial plasma were compared with hemodynamic variables in patients with heart diseases who underwent cardiac catheterization, a significant positive correlation was found between plasma ANP levels and mean pulmonary capillary wedge pressure, while plasma ANP levels were not significantly correlated to mean right atrial pressure (MRAP). After the injection of contrast medium, both MRAP and plasma ANP levels increased and a significant positive correlation was observed between two variables. Plasma levels of ANP were elevated in patients with congestive heart failure according to the severity. In addition, patients associated with atrial fibrillation showed significantly higher plasma ANP levels than those on sinus rhythm. In patients with paroxysmal atrial arrhythmias, plasma ANP levels increased markedly during paroxysms. Patients with chronic renal failure had elevated plasma ANP levels, which fell after hemodialysis. These results suggest that both left and right atrial tissue can secrete ANP as a result of stretching of the cardiocytes in man and that plasma ANP levels are elevated in patients with congestive heart failure and in those with chronic renal failure by increased atrial pressure due to volume expansion. Abnormal atrial contraction per se, in addition, may stimulate ANP secretion.
为了阐明心房利钠肽（ANP）在人体中的临床意义，对心脏病患者和慢性肾衰竭患者的免疫反应性ANP血浆水平进行了研究。将接受心导管检查的心脏病患者肺动脉血浆中的ANP浓度与血流动力学变量进行比较时，发现血浆ANP水平与平均肺毛细血管楔压之间存在显著正相关，而血浆ANP水平与平均右心房压（MRAP）无显著相关性。注射造影剂后，MRAP和血浆ANP水平均升高，且两个变量之间观察到显著正相关。充血性心力衰竭患者的ANP血浆水平根据严重程度而升高。此外，伴有心房颤动的患者血浆ANP水平显著高于窦性心律患者。阵发性房性心律失常患者在发作期间血浆ANP水平明显升高。慢性肾衰竭患者血浆ANP水平升高，血液透析后下降。这些结果表明，在人体中，由于心肌细胞的拉伸，左心房和右心房组织均可分泌ANP，并且充血性心力衰竭患者和慢性肾衰竭患者的血浆ANP水平因容量扩张导致心房压力升高而升高。此外，异常的心房收缩本身可能刺激ANP分泌。
