卡托普利治疗严重心力衰竭伴低钠血症的初步报告

报道血管紧张素转换酶抑制剂卡托普利治疗严重心力衰竭伴低钠血症１２例。结果表明：全心衰伴低钠血症的肾素，血管紧张素值显著升高，血清钠与肾素水平呈显著负相关（ｒ＝－０．６３０５，Ｐ＜０．０５），提示低钠血症是心衰病人肾素增高的指标。卡托普利对严重心力衰竭所致的低钠血症具有独特的治疗作用，但剂量宜小，并需加强血压，肾功能的监测。

Correction of Hyponatremia in Severe Congestive Heart Failure by Captopril

The effects of captopril in 12 cases of hyponatremia in severe congestive heart failure(CHF)were reported.The results showed that the plasma renin activity(PRA)was,very high and there was a strong negative correlation of PRA with serum sodium (r=-0.6305,p<0.01),which suggested a low serum sodium appeared to be a fairly reliable indication of high PRA in heart failure,and serum sodium concentration increased from 130.1±2.6 to 135.3±2.7 mmol/L(p<0.01)after 2-week captopril therapy.These findings supported that the reninangio-tensin system was important in that pathogenesis of hyponatremia in CHF and indicated that converting enzyme inhibition with captopril is an effective approach to the management of hyponatremia in CHF.Cautions are needd,however,because of their dependence on angiotensin for support of systemic and renal blood preasure,captopril therapy should be initiated in low doses,and under careful monitoring of blood pressure and renal function.