接受血液透析治疗患者的血浆利钠肽浓度

Plasma concentrations of natriuretic peptides in patients on hemodialysis.

作者信息

Takahashi M, Nagake Y, Ichikawa H, Kawabata K, Nakazono H, Hirata K, Ogura T, Makino H

机构信息

Third Department of Internal Medicine, Okayama University Medical School, Japan.

出版信息

Res Commun Mol Pathol Pharmacol. 1996 Apr;92(1):19-30.

PMID:8733825

Abstract

The usefulness of plasma atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), C-type natriuretic peptide (CNP), and cyclic guanosine 3',5'- monophosphate (cGMP) as markers of fluid overload was examined in hemodialysis (HD) patients without diabetes mellitus. Plasma concentrations of ANP, BNP, CNP, and cGMP all decreased significantly during HD. Before HD, there was a strong correlation between plasma concentrations of ANP and those of BNP, and plasma concentrations of cGMP correlated significantly with those of all three natriuretic peptides. The cardiothoracic ratio also correlated significantly with plasma concentrations of ANP and those of BNP before HD. Systolic blood pressure correlated significantly only with plasma concentrations of CNP, both before and after HD. Changes in body weight during HD correlated only with those in plasma ANP; there was thus no correlation between changes in body weight and those in plasma CNP. In conclusion, only plasma ANP is a useful marker of the proper volume and dry weight of HD patients. Furthermore, CNP may participate in cardiovascular regulation in HD patients in a manner different from those of ANP and BNP.

摘要

在无糖尿病的血液透析（HD）患者中，研究了血浆心房利钠肽（ANP）、脑利钠肽（BNP）、C型利钠肽（CNP）和环磷酸鸟苷（cGMP）作为液体超负荷标志物的有用性。在血液透析期间，ANP、BNP、CNP和cGMP的血浆浓度均显著下降。在血液透析前，ANP的血浆浓度与BNP的血浆浓度之间存在很强的相关性，并且cGMP的血浆浓度与所有三种利钠肽的血浆浓度均显著相关。心胸比率在血液透析前也与ANP的血浆浓度和BNP的血浆浓度显著相关。收缩压仅在血液透析前后均与CNP的血浆浓度显著相关。血液透析期间体重的变化仅与血浆ANP的变化相关；因此，体重变化与血浆CNP的变化之间没有相关性。总之，只有血浆ANP是血液透析患者合适容量和干体重的有用标志物。此外，CNP可能以不同于ANP和BNP的方式参与血液透析患者的心血管调节。