Plasma atrial natriuretic peptide (ANP) levels in patients with chronic lung diseases and its significance in evaluating remedial value for col pulmonale.

为探讨心钠素（ANP）是否参与肺心病的发生，测定了慢性肺疾病患者血浆ANP浓度和血流动力学参数：1）测定33例慢性肺疾病患者在室内空气下仰卧位右心导管术中静脉、动、静脉混合血浆ANP浓度。混合静脉血（PA）、动脉血（A）和静脉血（V）血浆ANP水平差异有显著性（PA vs A，P<0.05; A vs V，P<0.01; PA Vs V，P<0.01）。结果表明：（1）17例慢性肺疾病患者冷加压试验后5分钟血浆ANP水平升高，而冷加压试验后5分钟血浆ANP水平无明显变化;（2）17例慢性肺疾病患者冷加压试验后5分钟血浆ANP水平升高，而冷加压试验后5分钟血浆ANP水平无明显变化 ...更多信息 就在测试之后。由于血液动力学参数的变化和血浆儿茶酚胺水平的升高在试验早期就已观察到，因此ANP的分泌可能不是由神经源性刺激调节的，而是继发于血液动力学变化或激素因素。3）测定慢性阻塞性肺疾病（COPD）患者在给予28%氧气或氨茶碱（5 mg/Kg）前后血浆ANP水平。运动时血浆心钠素水平升高，但氨茶碱（5 mg/Kg）可显著降低运动时血浆心钠素水平的升高程度。4）运动时血浆心钠素水平升高，而氨茶碱（5 mg/kg）可显著降低运动时的升高程度。提示血浆心钠素水平可反映慢性肺源性心脏病患者右心负荷状态，对评价肺心病的治疗价值有一定意义。少

To clarify whether atrial natriuretic peptide (ANP) is involved in developing col pulmonale, measurements were made of plasma ANP concentrations and hemodynamic parameters in patients with chronic lung diseases under some conditions mentioned below:1)We measured mixed venous, arterial and venous plasma ANP levels in 33 patients with chronic lung diseases during right heart catheterization in the supine position under room air. We found significant differences in plasma ANP levels among mixed venous (PA), arterial(A) and venous(V) blood (PA vs A, P<0.05; A vs V, P<0.01; PA Vs V, p<0.01). The difference between mixed venous and arterial plasma ANP levels is attributed to ANP consumption during pulmonary circulation, which suggests that ANP may have some physiological effects on pulmonary circulation in patients with chronic lung diseases.2)Elevated plasma ANP levels were observed 5 minutes after cold pressor test in 17 patients with chronic lung diseases whereas no change could be found … More just after the test. Since the changes in hemodynamic parameters and elevated plasma catecholamine levels were seen early in the test, the secretion of ANP may be modulated not by neulogenic stimulation but secondary to hemodynamic changes or by hormonal factors.3)Plasma ANP levels were measured before and after administration of 28% oxygen or aminophylline (5mg/Kg) in patients with chronic obstructive pulmonary disease (COPD). Plasma ANP levels were significantly reduced concomitantly with reduction of right heart load after each administration.4)Plasma ANP levels were elevated during exercise, but the degree of elevation was significantly lowered during exercise after administration of aminophylline (5mg/Kg).4)Plasma ANP levels were elevated during exercise, but the degree of elevation was significantly lowered during exercise after adminophylline lowered during exercise after administration of aminophylline (5mg/kg). These findings suggest that plasma ANP levels reflect the state of right heart load in patients with chronic lung diseases and that plasma ANP levels are useful to evaluate remedial value of col pulmonale. Less