Pedersen E B, Danielsen H, Eiskjaer H, Jespersen B, Sørensen S S
Department of Medicine C, Aarhus Kommunehospital, Denmark.
Scand J Clin Lab Invest. 1988 Apr;48(2):141-7. doi: 10.3109/00365518809085406.
Atrial natriuretic peptide (ANP), angiotensin II (Ang II), and aldosterone (Aldo) in plasma and creatinine clearance (Ccr) were determined during basal conditions in 17 patients with the nephrotic syndrome and 20 control subjects. In addition, six of the patients were studied after seven remissions of the syndrome. In the nephrotic syndrome ANP was higher than in the control group (9.7 (median) versus 7.2 pmol/l, p less than 0.01), Ccr was lower (55 versus 99 ml/min, p less than 0.01). Angiotensin II and Aldo were the same in patients and control subjects. After remission of the syndrome ANP was reduced (11.2 to 5.4 pmol/l, n = 7, p less than 0.02) and Ccr increased (52 to 84 ml/min, n = 7, p less than 0.02), whereas Ang II and Aldo were unchanged. A significant, negative correlation was found between ANP and Ccr in the subgroup of patients in whom the syndrome remitted (Q = -0.547, n = 14, p less than 0.05). Atrial natriuretic peptide was not correlated to either Ang II or Aldo in either of the groups. It is concluded that patients with the nephrotic syndrome have elevated ANP, and it is suggested that a high ANP may be a compensatory phenomenon induced by a decreased renal ability to eliminate sodium and water.
在基础状态下，对17例肾病综合征患者和20例对照者测定了血浆中的心房利钠肽（ANP）、血管紧张素II（Ang II）和醛固酮（Aldo）以及肌酐清除率（Ccr）。此外，对其中6例患者在肾病综合征缓解7次后进行了研究。肾病综合征患者的ANP高于对照组（中位数分别为9.7与7.2 pmol/l，p<0.01），Ccr低于对照组（分别为55与99 ml/min，p<0.01）。患者和对照者的血管紧张素II和醛固酮水平相同。综合征缓解后，ANP降低（从11.2降至5.4 pmol/l，n = 7，p<0.02），Ccr升高（从52升至84 ml/min，n = 7，p<0.02），而血管紧张素II和醛固酮无变化。在综合征缓解的患者亚组中，ANP与Ccr之间存在显著的负相关（Q = -0.547，n = 14，p<0.05）。两组中ANP与血管紧张素II或醛固酮均无相关性。结论是肾病综合征患者的ANP升高，提示高ANP可能是肾脏排钠排水能力下降引起的一种代偿现象。
