培哚普利对慢性充血性心力衰竭病人血清地高辛浓度和肾功能的影响

目的 :探讨培哚普利对慢性充血性心力衰竭 (CCHF)病人血清地高辛和肾功能的影响。方法 :32例心功能Ⅲ～Ⅳ级的CCHF病人给地高辛0 .2 5mg ,po ,qd× 1wk ,继而地高辛剂量改为 0 .12 5～ 0 .2 5mg ,po ,qd× 4wk ;给地高辛wk 1末后开始给培哚普利 2～ 4mg ,po ,qd× 4wk。结果 :培哚普利治疗前、治疗wk 2末和wk 4末其血清地高辛浓度分别为 ( 1.14±s 0 .13) ,( 1.2 3± 0 .0 6)和 ( 1.2 3±0 .12 )nmol·L- 1,治疗前后差异无显著意义 (P >0 .0 5) ;血钾上升 ,但在正常范围 ;血尿素氮、肌酐、尿酸和 β2 微球蛋白均略有下降 ,纠正肌酐清除率至wk 4末有显著升高 (P <0 .0 1)。结论 :培哚普利能改善CCHF病人的肾功能 ,不增加地高辛的浓度

Effects of perindopril on serum digoxin level and kidney function in patients with chronic heart failure

AIM: To observe the efficacy of perindopril on serum digoxin and renal function in patients with chronic congestive heart failure(CCHF). METHODS:Thirtytwo patients with CCHF of heart function 3-4 degrees were treated with digoxin 0.25 mg,po,qd×1 wk, and then, 0.125-0.25 mg, po, qd×4 wk. They were treated with perindopril 2-4 mg,po,qd×4 wk after having been treated with digoxin for 1 wk. RESULTS: Digoxin concentration in serum before treatment with perindopril, at the end of 2 wk and 4 wk were (1.14±s 0.13 ),(1.23±0.06) and (1.23±0.12) nmol·L -1 , respectively. Changes of digoxin concentration in serum showed no significant difference (P>0.05) after the patients were treated with perindopril.Serum BUN, Cr, UA, β 2MG tended to drop (P<0.01). Serum K+ tended to increase. But it is within the normal range.Correct Ccr increased notablely (P<0.01) after 4 wk. CONCLUSION: Perindopril can improve kidney function in patients with CCHF and does not increase serum digoxin concentration.