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[心房利钠因子、儿茶酚胺与肾素-血管紧张素系统在心脏功能不全中的作用。与血流动力学参数的关系]

[Atrial natriuretic factor, catecholamines and the renin-angiotensin system in cardiac insufficiency. Relation to hemodynamic parameters].

作者信息

Komajda M, Carayon A, Nguyen J P, Maistre G, Drobinski G, Legrand S, Landault C, Legrand J C, Grosgogeat Y

机构信息

Service de cardiologie, CHU Pitié-Salpêtrière, Paris.

出版信息

Arch Mal Coeur Vaiss. 1988 Jul;81(7):845-53.

PMID:2973293
Abstract

Plasma concentrations of atrial natriuretic factor (ANF), catecholamines (adrenaline, noradrenaline, dopamine) and aldosterone, and plasma renin activity (PRA) were measured in a group of 20 patients with moderate to medium heart failure (NYHA class II 7 patients, class III 13 patients), 24 hours after treatment was discontinued. Compared with a control group, plasma concentrations of ANF (p less than 0.01), noradrenaline (p less than 0.05), aldosterone (p less than 0.01) and PRA (p less than 0.01) were significantly increased. There was a significant difference between class II patients and class III patients in plasma ANF (p less than 0.01) and noradrenaline (p less than 0.02) concentrations, but not in PRA and aldosterone levels. A significant correlation was observed between plasma ANF concentration and left ventricular end-diastolic pressure (r = 0.68, p less than 0.001), pulmonary arterial pressure (r = 0.59, p less than 0.01), pulmonary capillary pressure (r = 0.51, p less than 0.02), cardiac index (r = 0.46, p less than 0.05) and left ventricular end-diastolic volume (r = 0.50, p less than 0.05). However, ANF concentration was not correlated with mean right atrial pressure. Plasma adrenaline concentration correlated with systemic arterial resistance (r = 0.80, p less than 0.001), pulmonary arterial pressure (r = 0.57, p less than 0.02), mean pulmonary capillary pressure (r = 0.62, p less than 0.001), cardiac index (r = 0.53, p less than 0.05) and left ventricular end-diastolic pressure (r = 0.58, p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

摘要

在一组20例中度至重度心力衰竭患者(纽约心脏协会II级7例,III级13例)中,在停药24小时后测量血浆心房利钠因子(ANF)、儿茶酚胺(肾上腺素、去甲肾上腺素、多巴胺)和醛固酮的浓度以及血浆肾素活性(PRA)。与对照组相比,血浆ANF(p<0.01)、去甲肾上腺素(p<0.05)、醛固酮(p<0.01)和PRA(p<0.01)的浓度显著升高。II级患者和III级患者在血浆ANF(p<0.01)和去甲肾上腺素(p<0.02)浓度上存在显著差异,但在PRA和醛固酮水平上无差异。观察到血浆ANF浓度与左心室舒张末期压力(r = 0.68,p<0.001)、肺动脉压(r = 0.59,p<0.01)、肺毛细血管压(r = 0.51,p<0.02)、心脏指数(r = 0.46,p<0.05)和左心室舒张末期容积(r = 0.50,p<0.05)之间存在显著相关性。然而,ANF浓度与平均右心房压力无关。血浆肾上腺素浓度与全身动脉阻力(r = 0.80,p<0.001)、肺动脉压(r = 0.57,p<0.02)、平均肺毛细血管压(r = 0.62,p<0.001)、心脏指数(r = 0.53,p<0.05)和左心室舒张末期压力(r = 0.58,p<0.01)相关。(摘要截断于250字)

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