Suda S, Weidmann P, Saxenhofer H, Cottier C, Shaw S G, Ferrier C
Medizinische Poliklinik, University of Berne, Switzerland.
Hypertension. 1988 May;11(5):483-90. doi: 10.1161/01.hyp.11.5.483.
The relationship between kidney function and plasma immunoreactive atrial natriuretic factor (irANF) levels as well as the effects of synthetic human ANF-(99-126) were investigated in 13 patients with mild to moderate chronic renal failure. Under basal conditions, glomerular filtration rate averaged 39 +/- 5 (SEM) ml/min/1.73 m2 and blood pressure (BP) averaged 166/107 +/- 7/2 mm Hg; 12 patients were hypertensive. Plasma irANF levels were significantly increased (98 +/- 16 vs 42 +/- 4 pg/ml in healthy control subjects; p less than 0.001) and correlated (p less than 0.05-0.005) inversely with hematocrit (r = -0.65) and positively with systolic BP (r = 0.75) or fractional sodium excretion (r = 0.75). Human ANF-(99-126) infusion for 45 minutes at 0.034 microgram/kg/min augmented (p less than 0.05-0.01) diuresis and urinary sodium, chloride, calcium, phosphate, and magnesium excretion. During the subsequent 45 minutes of human ANF-(99-126) infusion at a rate of 0.077 microgram/kg/min, diuresis and electrolyte excretion remained elevated (p less than 0.05-0.01). Glomerular filtration rate and effective renal plasma flow were not significantly modified, but filtration fraction rose progressively (p less than 0.01). Human ANF-(99-126) infusion decreased BP (p less than 0.05-0.01), produced hemoconcentration (hematocrit + 7%; p less than 0.01) without negative body fluid balance, and increased (p less than 0.01-0.001) plasma norepinephrine, insulin, and serum free fatty acids; plasma aldosterone and renin activity were unaltered during but rose after cessation of human ANF-(99-126) infusion.(ABSTRACT TRUNCATED AT 250 WORDS)
对13例轻至中度慢性肾衰竭患者的肾功能与血浆免疫反应性心钠素（irANF）水平之间的关系以及合成人ANF-(99 - 126)的作用进行了研究。在基础状态下，肾小球滤过率平均为39±5（标准误）ml/min/1.73 m²，血压（BP）平均为166/107±7/2 mmHg；12例患者患有高血压。血浆irANF水平显著升高（健康对照者为42±4 pg/ml，而患者为98±16 pg/ml；p<0.001），并且与血细胞比容呈负相关（r = -0.65；p<0.05 - 0.005），与收缩压呈正相关（r = 0.75）或与钠排泄分数呈正相关（r = 0.75）。以0.034微克/千克/分钟的速率输注人ANF-(99 - 126) 45分钟可增加（p<0.05 - 0.01）尿量以及尿钠、氯、钙、磷和镁的排泄。在随后以0.077微克/千克/分钟的速率输注人ANF-(99 - 126)的45分钟内，尿量和电解质排泄仍保持升高（p<0.05 - 0.01）。肾小球滤过率和有效肾血浆流量无显著改变，但滤过分数逐渐升高（p<0.01）。输注人ANF-(99 - 126)可降低血压（p<0.05 - 0.01），导致血液浓缩（血细胞比容增加7%；p<0.01）且无体液负平衡，并增加（p<0.01 - 0.001）血浆去甲肾上腺素、胰岛素和血清游离脂肪酸；输注人ANF-(99 - 126)期间血浆醛固酮和肾素活性未改变，但在输注停止后升高。（摘要截取自250字）
