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目的了解慢性肾衰（ＣＲＦ）患者应用转换酶抑制剂（ＡＣＥＩ）后血浆心钠素（ＡＮＦ）和肾素－血管紧张素系统（ＲＡＳ）激素的相互影响。方法不限钠情况下，禁食１０ｈ，口服开博通５０ｍｇ，测定ＡＮＦ、血浆肾素活性（ＰＲＡ）、血管紧张素Ⅱ（ＡＴⅡ）和平均动脉压（ＭＡＰ）。用均数配对ｔ检验和线性回归作统计分析。结果肾衰组基础ＡＮＦ、ＲＡＳ激素和ＭＡＰ均高于对照组。药后两组ＡＴⅡ于２４０ｍｉｎ明显受抑制，程度相似。两组ＭＡＰ随ＡＴⅡ下降而下降，呈明显正相关。两组ＡＮＦ缓慢上升，于２４０ｍｉｎ升幅均达６５％，与ＡＴⅡ和ＭＡＰ下降呈明显负相关。结论ＣＲＦ患者的ＲＡＳ激素和ＡＮＦ均处亢进状态，对ＡＣＥＩ敏感性与正常人相似；ＡＮＦ的变化可作为ＣＲＦ患者对ＡＣＥＩ敏感性的指标，以避免ＡＣＥＩ对肾脏的有害影响。
Objective To investigate the interaction between plasma renin-angiotensin system (ANF) and renin-angiotensin system (RAS) hormones after conversion enzyme inhibitor (ACEI) in patients with chronic renal failure (CRF). Methods All patients were fasted for 10 hours under the condition of sodium fasting, 50 mg of ketoprofen was given orally, and ANF, plasma renin activity (PRA), angiotensin Ⅱ (AT Ⅱ) and mean arterial pressure (MAP) were measured. The mean pairing t-test and linear regression were used for statistical analysis. Results The basal levels of ANF, RAS and MAP in renal failure group were higher than those in control group. After treatment, ATⅡ in the two groups was obviously inhibited at 240min, with similar degrees. MAP decreased with the decline of AT Ⅱ in both groups, showing a significant positive correlation. The ANF of both groups increased slowly, reaching 65% in 240min, and negatively correlated with the decrease of ATⅡ and MAP. CONCLUSIONS: Both RAS and ANF levels in patients with CRF are hyperactive and their sensitivity to ACEI is similar to that of normal subjects. The changes of ANF may be used as an index of sensitivity to ACEI in patients with CRF to avoid the harmful effects of ACEI on the kidneys.