心房颤动患者血浆心房利钠肽动态变化

Dynamic Changes of Plasma Atrial Natriuretic Peptide in Patients with Auricular Fibrillation

本文动态的观察了28例房颤发作及转复后血浆、血清、尿液心房利钠肽(ANP)的浓度变化,试图探索其演变规律及寻找更为简便的测定方法,供临床应用。结果,发现房颤发作时,血浆 ANP 水平明显高于转复后,与文献报道相一致。对比发作与缓解时血清和血浆 ANP 的变化相似,但差异不够显著,且二者之间无相关性。房颤发作时尿 ANP 的排出量明显高于房颤缓解后,为首次报告。同时观察了发作时与转复后的血压、心室率、尿量、尿渗透压、钠、钾、肌酐等,均未见显著差异。病程的长短、房颤发作的频度、心功能的状态,对 ANP 均未见明显影响。提示,ANP 的合成与释放,可能与房性心律失常时心房壁所受的牵拉程度及其弹性等因素有关。测定血清或尿中 ANP 含量的方法,值得进一步研究。

Twenty-eight Patients with auricular fibrillation(AF)were investigated forplasma atrial natriuretic peptide(ANP)determination during and after theirparoxysms.Plasma levels of ANP showed significantly higher values during AFattacks than those of silent periods(609.5±40.6 vs 397.4±51.2pg/ml,P<0.05).At the same time,serum ANP concentration and urine ANP elimination werealso studied searching for more simple methods in clinical use.The result also gavehigher figures during AF episodes.Increased plasma ANP in patients with AF,inspite of the length of the course or the condition of cardiac function,indicatedthat atrial arrhythmias might play an important role in ANP synthesis and secretion.The mechanism is by force not only of intracavitary pressure(such as in heart fai-lure)but also of the degree of atrial wall stress and the wall elasticity.