阿米洛利或吲达帕胺对血清地高辛浓度的影响  

Amiloride or indapamide to the influence of serum digoxin concentration in chronic heart failure patients

作　　者：吴小庆[1] 朱剑秋[1] 王强[1] 薄小萍[1] 

机构地区：[1]无锡市第一人民医院心内科,无锡214002

出　　处：《中国临床药学杂志》2004年第6期342-345,共4页Chinese Journal of Clinical Pharmacy

摘　　要：目的 :观察在充血性心力衰竭时合用阿米洛利或吲达帕胺对血清地高辛浓度的影响。方法 :以自身前后对照 ,每 2wk为 1个阶段。第 1阶段为对照期 ,患者服地高辛 0 2 5mg ,qd ,于d 14测血清地高辛浓度、电解质、BUN、Cr、肌酐清除率、血地高辛清除率 ;第 2、3阶段分别加用阿米洛利 5、10mg ,qd或吲达帕胺 2 5、5mg,qd ,分别于每一阶段的d 7、14复查上述项目。结果 :地高辛联用阿米洛利后第 2阶段d 14 ,血清地高辛浓度增高 2 7 6 % ,第 3阶段的d 7,14分别增高 2 9 3%和 2 7 7% (P均 <0 0 1) ,同时伴有肌酐清除率、血地高辛清除率的降低。而地高辛联用吲达帕胺后第 2阶段d 14 ,血清地高辛浓度稍有上升 ,第3阶段的d 7、14 ,血清地高辛浓度与前相仿并稍有所下降 (P >0 0 5 ) ,而BUN、肌酐清除率、地高辛清除率均无明显变化 ,2组对患者心功能的改善基本相仿。结论 :在充血性心力衰竭时地高辛联用阿米洛利可导致血清地高辛浓度的升高 ,同时伴有肌酐清除率、血地高辛清除率的降低 ;AIM: To observe and compare the action of amiloride and indapamide on serum digoxin concentration and cardiac function in chronic heart failure. METHODS: Thirty patients with chronic heart failure got digoxin 0.25 mg qd for 14 d, then were divided into 2 groups, one added indapamide 2.5 mg qd for 14 d then 5 mg, qd for 14 d and another added amiloride 5 mg qd for 14 d then 10 mg qd for 14 d. After every 7d serum digoxin concentration, creatinine, creatinine clearance rate, digoxin clearance rate and cardiac function were examined. RESULTS: After 2 wk in amiloride group the serum digoxin concentration was rised 27.6%(P<0.01), and after next 7 d, 14 d the serum digoxin concentration roise 29.3% and 27.7% respectively (P<0.01) and compare creatinine clearance rate, digoxin clearance rate decreased. But in indapamide group serum digoxin concentration, creatinine clearance rate, digoxin clearance rate had no significantly changes(P>0.05). CONCLUSION: The combined use of digoxin and amiloride can result in serum digoxin concentraed increased and creatinine clearance rate, digoxin clearance rate decreased. But combined use of digoxin and indapamide can not result in serum digoxin concentration, creatinine clearance rate,and digoxin clearance rate obviously change. The increase of serum digoxin concentration by amiloride is due to the reduce of digoxin’s excretion by kidneys. So in the combination of digoxin and Amiloride we should monitoring serum digoxin concentration or reduce the dosage of amiloride.

关 键 词：阿米洛利 吲达帕胺 地高辛 血药浓度 充血性心力衰竭 

分 类 号：R541.6[医药卫生—心血管疾病]