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

为探讨心房利钠肽(ANP)在慢性肺病发生发展中的作用，本文测定了33例慢性肺病患者右心插管时的血浆ANP浓度及血流动力学参数。我们发现混合静脉血(PA)、动脉血(A)和静脉血(V)的血浆ANP水平有显著差异(PA vs A，P&lt；0.05；A vs V，P&lt；0.01；PA vs V，P&lt；0.01)。2)17例慢性肺病患者冷加压试验后5分钟血浆心钠素水平升高，而…无明显变化更多的是在测试之后。由于血流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可见，因此ANP的分泌可能不受新生刺激的调节，而是继发于血流动力学变化或激素因素。3)测定慢性阻塞性肺疾病(COPD)患者吸入28%氧气或氨茶碱(5 mg/kg)前后的血浆ANP水平。4)服用氨茶碱(5 mg/kg)后，运动时血浆ANP水平升高，但升高幅度明显降低。4)服用氨茶碱(5 mg/kg)后，运动时血浆ANP水平升高，但升高幅度明显降低。提示血浆ANP水平反映了慢性肺病患者的右心负荷状态，血浆ANP水平有助于评价肺心病的治疗价值。较少

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