Jespersen B, Pedersen E B
Department of Medicine C, Aarhus Kommunehospital, Denmark.
Nephrol Dial Transplant. 1988;3(6):762-7.
Basal plasma atrial natriuretic peptide (ANP) and blood pressure were measured in 11 patients with chronic renal failure before requirement of dialysis, 13 patients on chronic dialysis, and 28 control subjects (Study 1). Changes in ANP during noradrenaline infusion were determined in eight patients with chronic renal failure before dialysis, 12 patients on chronic dialysis, and 17 control subjects (Study 2). ANP was also measured in 14 healthy control subjects during angiotensin II infusion (Study 3). Study 1 showed a significantly greater ANP in patients before the stage of dialysis (median 23 pg/ml) and in dialysis patients (34 pg/ml) than in control subjects (19 pg/ml) P less than 0.01 for both. In Study 2, noradrenaline induced an increase in ANP in the non-dialysed patients (P less than 0.05) and in the control subjects (P less than 0.01), but not in the dialysis patients. According to Study 3, ANP was unchanged during angiotensin II infusion. Blood pressure was increased in all groups during noradrenaline and angiotensin II infusions. It can be concluded that ANP Is increased both in patients with chronic renal failure before requirement of dialysis and in patients on maintenance dialysis. It is suggested that noradrenaline stimulates ANP release.
对11例尚未开始透析的慢性肾衰竭患者、13例接受慢性透析的患者以及28例对照受试者测量了基础血浆心钠素（ANP）和血压（研究1）。对8例尚未开始透析的慢性肾衰竭患者、12例接受慢性透析的患者以及17例对照受试者，测定了去甲肾上腺素输注期间心钠素的变化（研究2）。还对14例健康对照受试者在输注血管紧张素II期间测量了心钠素（研究3）。研究1显示，尚未进入透析阶段的患者（中位数23 pg/ml）和透析患者（34 pg/ml）的心钠素水平显著高于对照受试者（19 pg/ml），两者P均小于0.01。在研究2中，去甲肾上腺素使未透析患者（P小于0.05）和对照受试者（P小于0.01）的心钠素水平升高，但未使透析患者的心钠素水平升高。根据研究3，在输注血管紧张素II期间，心钠素水平未发生变化。在输注去甲肾上腺素和血管紧张素II期间，所有组的血压均升高。可以得出结论，尚未开始透析的慢性肾衰竭患者和维持性透析患者的心钠素水平均升高。提示去甲肾上腺素可刺激心钠素释放。
