二尖瓣球囊成形术后患者血浆心钠素浓度的动态变化  

The Dynamic Change of Plasma Atrial Natriuretic Factor after Percutaneous Balloon Mitral Valvuloplasty

作　　者：李大主 曹林生[1] 刘幼文 张(音页)龙 李裕舒[1] 曾秋棠[1] 吴桂芳[1] 李刚 

机构地区：[1]同济医科大学心血管病研究所

出　　处：《同济医科大学学报》1992年第5期308-310,共3页Acta Universitatis Medicinae Tongji

摘　　要：为了评价左房压力骤降对心钠素分泌的影响,我们观察了23例严重二尖瓣狭窄患者经二尖瓣球囊成形术(PBMV)治疗后血浆心钠素(ANF)浓度的变化。结果表明,术后即刻左房压力显著下降(前后分别为2.53±0.28与1.11±0.21 kPa,P<0.001),而右房压、平均动脉压及心率均无显著变化;术前血浆ANF明显高于正常,术后15min显著下降(前后分别为917.1±96.2与184.4±57.2ng/L,P<0.01),术后45min,24及48h处于同一低水平。PBMV前后ANF与左房压力明显相关(r=0.75,P<0.001)。提示,左房压升高,或由此引起的心房扩大,房壁张力增加是二尖瓣狭窄患者ANF分泌的重要刺激因素,心房肌细胞能迅速而灵敏地调节ANF分泌,以适应心房压力的变化。To assess the effect of rapid reduction of the left atrial pressure on the secretion of atrial natriuretic factor (ANF), we studied 23 patients with severe mitral stenosis during and after percutaneous balloon mitral valvuloplasty (PBMV). The left atrial pressure fell from 2.53±0.28 to 1.11 ±0.21 kPa immediately after the dilatation (P<0.001). However, no remarkable changes in the right atrial pressure, mean arterial pressure and the heart rate were observed. Plasma ANF level, which is elevated before PBMV, decreased from 317.1 ±96.2 ng/L to 164.4 ±57.2 ng/L min after the procedure (P<0.01) and remained at a low level 48 h after valvuloplasty. There was a significant correllation between the left atrial pressure and ANF before and after the dilatation (r=0.75, P< 0.001). These findings indicate that increased left atrial pressure is an important stimulus to ANF release in humans, and the atrial myocytes are sensitive to the short-term alteration of the left atrial pressure, thus being in a position to rapidly regulate its ANF secretion.

关 键 词：二尖瓣狭窄 球囊成形术 心钠素 

分 类 号：R542.510.7[医药卫生—心血管疾病]