Role of Atrial Natriuretic Peptide in Mineralocorticoid Escape Phenomenon in Patients with Primary Aldosteronism
Role of Atrial Natriuretic Peptide in Mineralocorticoid Escape Phenomenon in Patients with Primary Aldosteronism
复制标题
心钠素在原发性醛固酮增多症患者盐皮质激素逃逸现象中的作用
DOI：
--
复制
发表时间：
1987
期刊：
影响因子：
--
通讯作者：
K. Murata
中科院分区：
文献类型：
--
作者：
Tetsuya Nakamura;S. Ichikawa;T. Sakamaki;Kunio Sato;M. Kogure;Y. Tajima;Tatsuya Kato;K. Murata
摘要 在 5 名因腺瘤引起的原发性醛固酮增多症患者中，研究了螺内酯治疗对利尿钠排泄的戒断效应与心房钠尿肽 (ANP) 的关系。患者入院前已接受螺内酯治疗2-3个月。入院后每天测量血压、体重和尿钠排泄量。每周两次采集静脉样本，用于测量血浆 ANP 水平、血浆肾素活性 (PRA) 以及血浆醛固酮 (PAC)、皮质醇和脱氧皮质酮浓度。该研究在螺内酯治疗期间进行了 7 天，并在停止给药后进行了 18 天。在对照期间和停止螺内酯后第 13 天测定血浆体积两次。尿钠排泄量最初下降，随后逐渐恢复至对照水平。体重和血浆量增加，血压稳步上升。 PRA及血浆皮质醇和脱氧皮质酮浓度显着降低（P < 0.05）；然而，高水平的 PAC 并没有显着改变。血浆 ANP 水平显着增加（P < 0.05），从对照组期间的 26 ± 4 pg/ml 至停止螺内酯后第 13 天的 195 ± 47 pg/ml。尿钠排泄数据显示醛固酮的钠潴留作用逃逸，这种逃逸可以通过血浆ANP的增加来解释。此外，由于 ANP 对类固醇生成的直接抑制作用，ANP 可能会导致血浆中皮质醇和脱氧皮质酮的减少。
Abstract The withdrawal effect of spironolactone treatment on natriuresis was studied in relation to atrial natriuretic peptide (ANP) in five patients with primary aldosteronism due to adenoma. The patients had been treated with spironolactone for 2-3 months before they were admitted. After admission, blood pressure, body weight, and urinary excretion of sodium were measured daily. Venous samples were obtained twice a week for measurements of plasma levels of ANP, plasma renin activity (PRA), and plasma concentrations of aldosterone (PAC), Cortisol, and deoxycorticosterone. The study was performed for 7 days during the treatment with spironolactone and for 18 days after stopping the administration. Plasma volume was determined two times, during the control period and on the 13th day after stopping spironolactone. Urinary sodium excretion decreased initially and returned to the control levels successively. Body weight and plasma volume increased, and blood pressure rose steadily. PRA and the plasma concentrations of cortisol and deoxycorticosterone decreased significantly (P < 0.05); however, high levels of PAC did not alter significantly. Plasma ANP levels increased significantly (P < 0.05) from 26 ± 4 pg/ml during the control period to 195 ± 47 pg/ml on the 13th day after stopping spironolactone. The data of the urinary sodium excretion showed the escape from sodium-retaining effect of aldosterone, and this escape could be explained by the increase in plasma ANP. Furthermore, ANP might contribute to the decrease in cortisol and deoxycorticosterone in plasma because of the direct inhibitory action of ANP on steroidogenesis.
合成心房钠尿因子对牛肾上腺肾小球的作用。
影响因子：
6.1
作者：
Goodfriend,TL;Elliott,ME;Atlas,SA
通讯作者：
Atlas,SA
人血浆中具有免疫反应性的α-人心房钠尿多肽。
影响因子：
3
作者：
Naruse,M;Naruse,K;Obana,K;Kurimoto,F;Sakurai,H;Honda,T;Higashida,T;Demura,H;Inagami,T;Shizume,K
通讯作者：
Shizume,K