Ferri C, Di Francesco L, Baldoncini R, Bellini C, Desideri G, Carlomagno A, De Siati L, Santucci A, Balsano F
Fondazione Andrea Cesalpino, Istituto di I Clinica Medica, Università degli Studi di Roma La Sapienza.
Ann Ital Med Int. 1993 Apr-Jun;8(2):89-94.
Some predictive markers for NaCl sensitivity, related to the red blood cell membrane or to circulating proteins, have already been described in human essential hypertension. The present study was planned to investigate whether or not some hormones produced by the kidney or acting at the kidney level could be used as new markers for NaCl sensitivity. The study was conducted in 28 not previously treated outpatients affected by uncomplicated mild to moderate essential hypertension. After 15 days on a normal NaCl diet, plasma renin activity (PRA), plasma atrial natriuretic peptide (ANP), and the urinary excretion of active kallikrein were evaluated. The sensitivity of blood pressure to changes in NaCl intake was then assessed in all patients, according to a randomized double blind cross-over design. Each patient was assigned to a high (240 mmol of NaCl/day for 15 days) or low (40 mmol of NaCl/day for 15 days) NaCl intake. During the assessment of NaCl sensitivity, the double blindness was achieved by the use of capsules containing either NaCl or placebo. Fifteen patients (11 males and 4 females) resulted as NaCl-sensitive, while 13 patients (8 males and 5 females) were classified as NaCl-resistant. Our results indicate that PRA levels were significantly lower in the NaCl-sensitive group than in the NaCl-resistant one (0.108 +/- 0.05 ng/L/s vs 0.247 +/- 0.16 ng/L/s, p < 0.007), in the presence of raised levels of plasma ANP in NaCl-sensitive hypertensives (18.08 +/- 4.61 fmol/mL vs 12.45 +/- 3.77 fmol/mL, p < 0.006).(ABSTRACT TRUNCATED AT 250 WORDS)
在人类原发性高血压中，已经描述了一些与红细胞膜或循环蛋白相关的氯化钠敏感性预测标志物。本研究旨在调查肾脏产生的或作用于肾脏水平的某些激素是否可作为氯化钠敏感性的新标志物。该研究对28名未曾接受过治疗的门诊患者进行，这些患者患有单纯性轻度至中度原发性高血压。在正常氯化钠饮食15天后，评估血浆肾素活性（PRA）、血浆心钠素（ANP）和活性激肽释放酶的尿排泄量。然后根据随机双盲交叉设计，评估所有患者血压对氯化钠摄入量变化的敏感性。每位患者被分配到高（每天240 mmol氯化钠，共15天）或低（每天40 mmol氯化钠，共15天）氯化钠摄入量组。在评估氯化钠敏感性期间，通过使用含有氯化钠或安慰剂的胶囊实现双盲。15名患者（11名男性和4名女性）被判定为氯化钠敏感，而13名患者（8名男性和5名女性）被分类为氯化钠抵抗。我们的结果表明，在氯化钠敏感组中，PRA水平显著低于氯化钠抵抗组（0.108±0.05 ng/L/s对0.247±0.16 ng/L/s，p<0.007），而氯化钠敏感型高血压患者的血浆ANP水平升高（18.08±4.61 fmol/mL对12.45±3.77 fmol/mL，p<0.006）。（摘要截断于25字）
