P-中英双语解读-BNP-B型钠尿肽又称脑利钠肽生理作用与意义.docx

1、BNP脑利钠肽目录BNP脑利钠肽1BNP1BNP心衰分级3脑利钠肽B型钠尿肽又称脑利钠肽(Brain natriuretic peptide, BNP),是由心肌细胞合成的具有生物学活性的天然激素，主要在心室表达，同时也存在于脑组织中。KidneyHeartIncrease sodium and water excreation by: RAAS inhibition GFR increase renal SNS inhibition)Cardiac load reduction Hypertrophy inhibition Fibrosis inhibitionNatriuretic pep

2、tidesNervous systemVascular systemSNS inhibition Lowering of vagal afferents activation tresholdVasodilation Hypotensive efects Angiogenic efects当左心室功能不全时，由于心肌扩张而快速合成释放入血，有助于调节心脏功能。心肌 细胞所分泌的BNP先以108个氨基酸组成的前体形式存在，当心肌细胞受到刺激时，在活 化酶的作用下裂解为由76个氨基酸组成的无活性的直线多肽和32个氨基酸组成的活性环状 多肽，释放入血循环，分别被称为NT-proBNP和BNP。BNP

3、小于100pg/m 1可排除心衰。BNPB-type natriuretic peptide (BNP) belongs to a family of protein hormones called natriuretic peptides. Each member of the group is produced by a different part of the circulatory system. ANP is produced by the muscle cells in the upper pumping chambers of the heart (the atria); BN

4、P is produced in the larger and more powerful lower chambers (the ventricles); CNP is producedmainly in blood vessels; and DNP is found in the blood plasma but probably originates in the heart itself.These natriuretic peptides have an important role in regulating the circulation. Scientists have lea

5、rned the most about ANP and BNP. Both act on blood vessels, causing them to dilate, or widen.They also work on the kidneys, causing them to excrete more salt and water. In addition, the natriuretic peptides reduce the production of various hormones that narrow blood vessels, boost the heart rate, or

6、 affect fluid retention; examples include adrenaline, angiotensin, and aldosterone.AAdrenalsClearanceNPR-C & NEP| Blood volumeKidneysL t GFR ! * Natriuresist DiuresisI Renin(NPR-A)Peripheral vessa/s Vasodilatation* Permeability + 1 hematocrite (NPR-A, NPR-B)Centralsystemj Sympathetic toneI Arter

7、ialPressurej Vasopressin| CorticotrophinJ Salt a petitei Thirstf Venous returnHeartj Fibrosis j Hypertrophy(NPR-A)B t AldosteroneI Neuroendocrine function(NPR-A, NPR-B)The net effect of natriuretic peptides is to promote urine excretion, relax blood vessels, lower blood pressure, and reduce the hear

8、t's workload. They are part of the body's natural defense mechanisms designed to protect the heart from stress. And they surge into action when they are needed most, when the heart itself is under siege.核心提示：b型钠尿肽是一种天然激素，是由多种氨基酸组成的多肽，用于诊断急性心衰和慢性心衰，也可以用于心衰分级。b型钠尿肽心衰分级包括一级、二级和三级、四级， 不同级别b型钠尿肽的

9、指标是不一样的。患者发生心力衰竭，久治不愈会加重心脏负荷，容 易猝死。对于老年人，随着年龄的增长，身体机能不断退化，很容易发生心力衰竭。心力衰竭是 心脏疾病中最严重的一种，心力衰竭的发生和原发性疾病有密不可分的关系，比如高血压、 心脏病、糖尿病的。在平时患者要多了解心力衰竭等级，方便患者对症下药。下面为大家介 绍b型钠尿肽心衰的等级。关于b型钠尿肽心衰的等级，可分为四种级别。b型钠尿肽是诊断心衰严重程度的评估手段，b型钠尿肽又称为脑尿钠肽，是天然激素，有三十几种氨基酸组成的多肽，通过心室 表达。当b型钠尿肽水平持续升高或者是降低时，证明心衰进一步加重。BNP心衰分级b型钠尿肽心衰的等级，可分为

10、以下四种。第一，一级心力衰竭。b型钠尿肽指标为244±286,有心血管病变或者有心脏病，活动 不受任何限制。对于一级心力衰竭，一般不需要特殊治疗者，密切观察，定期到院检查心脏 功能。第二，二级心衰。b型钠尿肽指数为389±374,此时患者会发生轻微的症状，比如身体 疲劳、呼吸困难、心绞痛，心悸等，这些症状一般在活动时加重，休息时可自行缓解，日常 活动会受到轻微限制。第三，三级心衰。b型钠尿肽数值为640±447,患者会出现二级心力衰竭的症状，活动 受到明显的限制，血液循环不流畅，稍微不注意会诱发体循环淤血。 Salt appetiteI Water intake-

11、 Sympathetic outflow I Neuroendocrine functionKidney f GFR UNaV UV Renin (NPR-A)Clearance by NPR-C NEPa IANP BNPI Adrenal aldosteroneCentral nervous system (NPR-A, NPR-B)7CNP Corticotropin第四，四级心衰。四级心衰b型钠尿肽指标为817±435,在休息时除了发生以上症状之 外，过度劳累后，症状会加重，严重患者会引起猝死或休克，无法从事体力劳动，丧失生活 能力。.Blood Plasma ，. Venous returnpressure v