Pidlich J, Müller C, Hartter E, Renner F, Klepetko W, Miholic J, Woloszczuk W
II. Universitätsklinik für Gastroenterologie und Hepatologie, Wien.
Acta Med Austriaca. 1987;14(5):125-9.
Mean plasma levels of hANF at admission were significantly higher in liver cirrhosis (LC) patients with ascites (93 +/- 11 ng, n = 20; p less than 0.05) than in LC-patients without ascites (32 +/- 14 ng/l, n = 11) or healthy controls (31 +/- 15 ng/l; range: 5-80 ng/l; n = 106). Diuretic treatment of patients with LC and ascites normalised hANF plasma concentrations (44 +/- 14 ng/l; p less than 0.05). Increase of plasma hANF in LC-patients with ascites after acute volume expansion was lower (relative rise: 159%) than in those without ascites (relative rise: 223%). Volume redistribution into the vascular compartment, induced by peritoneovenous shunt implantation in LC-patients with diuretic treatment-refractory ascites, resulted in a sharp increase of plasma hANF levels (344 +/- 87 ng/l = 420% of preoperative concentration). Normal and slightly increased levels of plasma hANF and the appropriate regulation to volume changes suggest an intact control of the hormone in LC-patients. Neither a lack nor an inappropriate secretion of hANF as a cause for sodium retention as postulated by the overflow theory of ascites accumulation could be found in liver cirrhosis.
肝硬化（LC）腹水患者入院时人心房钠尿肽（hANF）的平均血浆水平（93±11 ng，n = 20；p<0.05）显著高于无腹水的LC患者（32±14 ng/l，n = 11）或健康对照者（31±15 ng/l；范围：5 - 80 ng/l；n = 106）。对LC腹水患者进行利尿治疗可使hANF血浆浓度恢复正常（44±14 ng/l；p<0.05）。急性扩容后，有腹水的LC患者血浆hANF的升高幅度（相对升高：159%）低于无腹水的患者（相对升高：223%）。对利尿治疗难治性腹水的LC患者进行腹腔静脉分流植入术，导致血管腔内液体重新分布，血浆hANF水平急剧升高（344±87 ng/l = 术前浓度的420%）。血浆hANF水平正常及轻度升高，且对容量变化有适当调节，提示LC患者体内该激素的调控功能完整。在肝硬化患者中，未发现如腹水积聚的溢流理论所假设的hANF缺乏或分泌不当是钠潴留的原因。
