La Villa G, Fronzaroli C, Lazzeri C, Porciani C, Bandinelli R, Vena S, Messeri G, Franchi F
Clinica Medica II, University of Florence School of Medicine, Italy.
J Clin Endocrinol Metab. 1994 May;78(5):1166-71. doi: 10.1210/jcem.78.5.8175974.
We evaluated the effects of pathophysiological levels of human brain natriuretic peptide (BNP), a recently identified cardiac hormone with natriuretic activity, by determining the hemodynamic and renal responses to low dose infusion (4 pmol/kg.min for 1 h, from 1500-1600 h) of human synthetic BNP in five healthy volunteers in a randomized placebo-controlled crossover study. Compared to placebo, BNP induced significant increases in effective renal plasma flow (para-aminohippurate clearance), glomerular filtration rate (creatinine clearance), urine flow rate, and sodium excretion without affecting blood pressure, heart rate, cardiac output (echocardiographic method), peripheral vascular resistance, PRA, plasma aldosterone, or plasma norepinephrine to any significant extent. Exploration of segmental sodium handling by the lithium clearance technique showed that the natriuretic effect of BNP was due to both an increase in filtered sodium load and a reduced distal sodium reabsorption. These results indicate that the high plasma BNP levels observed in disease states, such as heart failure, may contribute to the regulation of renal hemodynamics and sodium excretion.
我们通过在一项随机、安慰剂对照的交叉研究中，测定5名健康志愿者对低剂量输注（下午3点至4点，4皮摩尔/千克·分钟，持续1小时）人合成脑钠肽（BNP）的血流动力学和肾脏反应，评估了这种最近发现的具有利钠活性的心脏激素——人脑钠肽的病理生理水平的影响。与安慰剂相比，BNP可显著增加有效肾血浆流量（对氨基马尿酸清除率）、肾小球滤过率（肌酐清除率）、尿流率和钠排泄，而在任何显著程度上均不影响血压、心率、心输出量（超声心动图法）、外周血管阻力、肾素活性、血浆醛固酮或血浆去甲肾上腺素。用锂清除技术对分段钠处理进行的研究表明，BNP的利钠作用是由于滤过钠负荷增加和远端钠重吸收减少。这些结果表明，在诸如心力衰竭等疾病状态下观察到的高血浆BNP水平，可能有助于调节肾血流动力学和钠排泄。
