Interrelationship of atrial natriuretic peptide, atrial volume, and renal function in premature infants.
Interrelationship of atrial natriuretic peptide, atrial volume, and renal function in premature infants.
复制标题
早产儿心房钠尿肽、心房容量和肾功能的相互关系。
DOI：
10.1016/s0022-3476(05)82667-8
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发表时间：
1990
期刊：
影响因子：
--
通讯作者：
Linden,J
中科院分区：
文献类型：
--
作者：
Bierd,TM;Kattwinkel,J;Chevalier,RL;Rheuban,KS;Smith,DJ;Teague,WG;Carey,RM;Linden,J
婴儿在生命的最初几天经历了液体平衡的巨大变化，这为在相对较短的时间内观察心房大小变化、房利钠肽（ANP）分泌和肾功能的相互关系提供了机会。为了研究这些关系，我们对9名男婴（平均出生体重1180克，胎龄30周）在20至28小时时进行了检查，然后每隔4小时进行一次检查。测量包括血浆ANP浓度、二维超声心动图估计左右心房容积、多普勒测定动脉导管通畅、肌酐清除率、尿流率、尿钠排泄和环磷酸鸟苷（cGMP）排泄。血浆ANP浓度随着年龄的增长而下降，并与右心房缩小、动脉导管闭合、尿cGMP排泄和钠排泄相关。我们推测，在一个早产儿血浆ANP值升高反映了一个扩大的体积状态。当体积收缩时，心房容积和体重减少，ANP水平降低，这可能会减少利尿。这些发现与ANP在新生儿体积稳态中的重要作用相一致。
Infants experience dramatic changes in fluid balance during the first few days of life, which provides an opportunity to observe the interrelationships of changing atrial size, atrial natriuretic peptide (ANP) secretion, and renal function during a relatively short period. To study these relationships, we examined nine infant boys (mean birth weight 1180 gm and gestational age 30 weeks) at 20 to 28 hours of age and then at four 24-hour intervals. Measurements included plasma ANP concentration, two-dimensional echocardiographic estimations of left and right atrial volumes, Doppler determination of ductus arteriosus patency, creatinine clearance, urine flow rate, urinary sodium excretion, and cyclic guanosine monophosphate (cGMP) excretion. Plasma ANP concentration was found to decrease with age and to correlate with decreasing size of the right atrium, closure of the ductus arteriosus, urinary cGMP excretion, and sodium excretion. We speculate that elevated plasma ANP values in a preterm neonate reflect an expanded volume state. As volume contraction, reflected by decreasing atrial volume and body weight occurs, ANP levels decrease, which may diminish diuresis. These findings are compatible with a significant role for ANP in volume homeostasis of newborn infants.