慢性心不全の患者における尿経N端子プロホルモン脳ナトリウレチンペプチド分泌
Gerard C M Linssen1, Kevin Damman, Hans L Hillege
1Department of Cardiology, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands.
Circulation
|June 24, 2009
まとめ
尿中のN末端プロホルモン脳ナトリウレチンペプチド (NT-proBNP) の分泌は,心不全の患者で減少し,プラズマNT-proBNP濃度と逆に関連しています. 腎臓の血流量に関連したこの排出量の減少は,心不全におけるNT-proBNPの上昇を説明する可能性がある.
科学分野:
- 心臓病学 心臓病学
- ネフロロジーは腎臓科
- バイオマーカーの研究
背景:
- 尿による排泄は,N末端プロホルモン脳ナトリウレチンペプチド (NT-proBNP) の主要な排泄経路である.
- 心不全 (HF) 患者における尿中のNT-proBNPの測定の臨床的意義は不明である.
研究 の 目的:
- 慢性心不全 (CHF) 患者における尿中のNT-proBNP排出を調査する.
- 尿中のNT-proBNP,血のNT-proBNP,およびCHF患者の腎機能との関係を決定する.
主な方法:
- 94人のCHF患者と20人の健康な対照群を研究した.
- 放射性同位素クリアランスを用いて測定された球の濾過率と腎臓のプラズマフロー.
- 定量化プラズマおよび24時間の尿中のNT-proBNPレベル.
主要な成果:
- CHFの患者は,対照群と比較して,尿経NT-proBNPの分泌量が著しく低下した.
- 尿中のNT-proBNP排出は,血のNT-proBNP濃度と強い逆相関を示した.
- 腎臓の血流量の減少は,小球膜の濾過率ではないが,尿経NT-proBNPの排出量が低いと関連していた.
結論:
- 尿中のNT-proBNPの分泌はCHFで減少し,プラズマのNT-proBNPと逆に関連しています.
- 腎臓の血の流れは,小便によるNT-proBNPの排泄に影響し,これは球の濾過率とは無関係です.
- 尿排泄の減少は,心不全患者の血NT-proBNPの上昇に寄与する可能性があります.
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