References

rmt

Общая реаниматология

General Reanimatology

1813-97792411-7110

FSBI "SRIGR" RAMS

10.15360/1813-9779-2009-1-89

rmt-632

Research Article

ОБЗОРЫ И КРАТКИЕ СООБЩЕНИЯ

REVIEWS & SHORT COMMUNICATIONS

Натрийуретические пептиды: биохимия, физиология, клиническое значение

Natriuretic Peptides: Biochemistry, Physiology, Clinical Implication

Козлов

И. А.

Kozlova

I. A.

Харламова

И. Е.

Kharlamova

I. Ye.

2009

20022009

Том V № 1 2009 г.

8989

2009

Козлов И.А., Харламова И.Е.

Kozlova I.A., Kharlamova I.Y.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.reanimatology.com/rmt/article/view/632

В течение последних лет неуклонно возрастает интерес теоретиков и клиницистов к гормонам, секретируемых миокардом — натрийуретическим пептидам. На Конгрессе Европейского общества анестезиологов (Мюнхен, 2007) натрийуретические пептиды В-типа включили в перечень показателей периоперационного лабораторного мониторинга, целесообразного в практике анестезиологов-реаниматологов. В обзоре литературы освещена история открытия и идентификации различных типов натрийуретических пептидов, рассмотрены вопросы их биохимии. Подробно представлены сведения о синтезе, секреции и клиренсе этих пептидов, а также их рецептор-ном аппарате в различных органах и тканях. Вопросы физиологии системы регуляции, осуществляемой натрийуретическими пептидами описаны применительно к сердечно-сосудистой, выделительной, центральной нервной и нейроэндокринной системам. Специальное внимание уделено современным публикациям, посвященным использованию контроля натрийуретических пептидов В-типа как биомаркеров сердечной дисфункции. Проанализирована диагностическая и прогностическая значимость пептидов при хронической недостаточности кровообращения, ишемической болезни сердца, а также других кардиологических и некардиологических заболеваниях. Отдельно рассмотрены вопросы прогностической значимости повышенного уровня натрийуретичес-кого пептида В-типа в кардиохирургии. Сделано заключение, что изменения уровня натрийуретических пептидов В-типа в различных клинических ситуациях являются предметом многочисленных научных работ, в основном выполненных за рубежом. Большая часть этих исследований посвящена изучению пептидов в кардиологии и других областях терапии. Работы по изучению этих пептидов в реаниматологии относительно немногочисленны, а результаты таких исследований в достаточной степени неоднозначны. Изложенное открывает широкую перспективу для изучения НУП В-типа в российской интенсивной терапии и анестезиологии. Ключевые слова: натрийуретические пептиды, BNP, NT-proBNP.

In the past years, the interest of theorists and clinicians has steadily increased in the myocardially secreted hormones – natriuretic peptides. At the Congress of the European Society of Anesthesiology (Munich, 2007), B-type natriuretic peptides were included into the list of the parameters of perioperative laboratory monitoring that is expedient in the practice of anesthetists and resuscitation specialists. The literature review shows the history of discovery and identification of different types of natriuretic peptides and considers the matters of their biochemistry. It also details information on the synthesis, secretion, and clearance of these peptides, as well as their receptor apparatus in various organs and tissues. The physiology of the regulatory system is described, as applied to the cardiovascular, excretory, central nervous systems, and the neuroendocrine one. Special attention is given to the current publications on the control of B-type natriuretic peptides as biomarkers of cardiac dysfunction. The diagnostic and prognostic values of peptides are analyzed in chronic circulatory insufficiency, coronary heart disease, and other car-diological and non-cardiological diseases. The prognostic value of elevated B-type natriuretic peptide levels in cardiac surgery is separately considered. It is concluded that the changes in the level of B-type natriuretic peptides in different clinical situations are the subject of numerous researches mainly made in foreign countries. The bulk of these researches are devoted to the study of peptides in cardiology and other areas of therapy. Studies on the use of peptides in reanimatology are relatively few and their results are rather discordant. The foregoing opens up wide prospects for studying the use of B-type natriuretic peptides in Russian intensive care and anesthesiology. Key words: natriuretic peptides, brain nautriuretic peptides, NT-proBNP.

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The authors declare that there are no conflicts of interest present.