肝肾综合征患者血浆心钠素水平变化

Plasma levels of atrial natriuretic peptide in patients with hepatorenal syndrome

作者应用放射免疫法测定了正常人13例、肝硬变腹水19例和肝肾综合征17例(HRS)患者血浆心钠素(ANP)的含量.结果表明,HRS患者ANP水平(x±S_x为854.5±96.0 ng/L)明显高于正常人(451.9±47.5 ng/L,P<0.01),但与无肾功能损害的肝硬变腹水患者(825.3±90.6 ng/L)之间无显著差异(P>0.05).肝硬变腹水患者血浆ANP与肾素、血管紧张素Ⅱ呈显著正相关,伴HRS时却无相关关系.提示HRS并不是因缺乏ANP所致.HRS时,肾脏对ANP的反应性可能进一步降低.

The plasma levels of atrial natriuretic peptide (ANP) were determined by radioimmunoassay in 13 healthy volunteers and 19 patients with cirrhotic ascites and 17 with hepatorenal syndrome (HRS). The results revealed that plasma ANP was 8545±96.0 ng/L in patients with HRS compared with 825.3±90.6 ng/L (P>0.05) in patients with cirrhosis and normal renal function and 451.9±47.5 ng/L (P<0.01) in healthy subjects; plasma ANP showed no correlation with plasma renin activity (PRA) and angiotensin Ⅱ (AT Ⅱ), on the contrary, ANP positively correlated with PRA and AT Ⅱ in patients without HRS. The results indicate that HRS is not caused by a deficiency of circulating ANP, and might suggest a further insensitivity to the effects of ANP.