Nicholls M G, Richards A M
Endocrinology Department, Princess Margaret Hospital, Christchurch, New Zealand.
Endocrinol Metab Clin North Am. 1987 Mar;16(1):199-223.
The human heart secretes ANP, mainly or exclusively as the 1-28-amino-acid alpha-hANP. Secretion is increased when there is hypervolemia of the central circulation, either acute or chronic, the stimulus being, it is presumed, atrial stretch. The clearance rate of alpha-hANP has been documented in healthy volunteers but not in patients with clinical disorders. Injection or infusion of atrial peptides into normal humans has clear-cut hemodynamic, renal, and hormone effects. However, the doses used have been high and the results do not allow extrapolation to the realms of physiology. Patients with essential hypertension appear to have exaggerated renal responses to administered alpha-hANP, although the number of subjects studied is small and matching with normotensive controls was imperfect. By contrast, cardiac failure is characterized by impaired renal responses to atrial peptides. The place of atrial peptides in human physiology and pathophysiology is not clear and will require very low-dose infusion studies under exacting experimental conditions or the development of a specific inhibitor of circulating ANP. In theory, atrial peptides might find a place in therapeutics, most likely in cardiac failure or renal failure, but also essential hypertension if an orally active agonist can be developed.
人类心脏分泌心钠素（ANP），主要或仅分泌1 - 28个氨基酸的α - 人ANP。当存在急性或慢性的中心循环血容量过多时，其分泌会增加，推测刺激因素是心房牵张。α - 人ANP的清除率已在健康志愿者中得到记录，但在临床疾病患者中尚未记录。向正常人注射或输注心房肽会产生明确的血流动力学、肾脏和激素效应。然而，所使用的剂量很高，结果无法外推到生理领域。原发性高血压患者对给予的α - 人ANP似乎有过度的肾脏反应，尽管研究的受试者数量较少且与血压正常的对照组匹配并不理想。相比之下，心力衰竭的特征是对心房肽的肾脏反应受损。心房肽在人类生理学和病理生理学中的地位尚不清楚，这需要在严格的实验条件下进行极低剂量输注研究，或者开发一种循环ANP的特异性抑制剂。理论上，心房肽可能在治疗中占有一席之地，最有可能用于心力衰竭或肾衰竭，如果能开发出口服活性激动剂，也可用于原发性高血压。
