呋塞米静脉注射对高血压患者血浆醛固酮肾素比值的影响  

Effect of furosemide intravenous injection on plasma aldosterone to renin activity ratio in hypertensive patients

作　　者：吴小庆[1] 杨倩红[1] 薄小萍[1] 高运来[1] 顾向红[1] 王强[1] 羊镇宇[1] 邓燕芳[1] 

机构地区：[1]无锡市人民医院心内科,无锡市214023

出　　处：《中华老年多器官疾病杂志》2008年第4期295-298,共4页Chinese Journal of Multiple Organ Diseases in the Elderly

基　　金：2007年江苏省卫生厅课题资助项目(编号H200765)

摘　　要：目的研究大剂量呋塞米快速静脉注射激发试验对不同人群血浆醛固酮/肾素比值(ARR)的影响。方法10例血压正常人、28例高血压病患者、11例经CT薄层扫描等检查明确为原发性醛固酮增多症的患者入选。入选者在清晨平卧位抽取空腹血后静脉快速注射呋塞米40mg,注射后10、30min各抽血一次查血浆醛固酮水平及肾素活性(PRA)并计算出ARR。结果正常血压组的ARR为18.18,静脉注射呋塞米后,PRA迅速上升(P<0.01),ARR下降。高血压组患者的空腹血浆醛固酮为(149.01±14.69)ng/L,PRA为(3.45±0.74)ng/(ml.h),ARR为33.45±8.87,静脉注射呋塞米40mg后10、30min,患者的血浆醛固酮不断升高,分别为176.04,200.06ng/L,PRA明显升高,分别为7.11,5.68ng/(ml.h),ARR下降(均P<0.05)。原发性醛固酮增多症患者组ARR为38.61±15.16,PRA为(3.16±0.4)ng/(ml.h),醛固酮为(165.75±18.56)ng/L,用呋塞米40mg静脉推注后其ARR达41.70±18.46。结论快速静脉注射呋塞米可使正常血压者及高血压病患者醛固酮和PRA快速明显增加,PRA以10min时最明显,醛固酮以30min最明显,ARR有所下降,而原发性醛固酮增多症患者的PRA上升不明显,ARR反而有所增加。Objective To study the change of plasma aldosterone （ALD） to plasma renin activity （PRA） ratio （ARR） after 40mg furosemide intravenous injection in hypertensive patients. Methods Ten people with normal blood pressure, 28 with hypertension and 11 with primary aldosteronism were examined for the change of ALD, PRA and ARR before and 10min, 30min after 40mg furosemide intravenous injection. Meanwhile the changes of blood pressure and heart rate were monitored. Results In control group, ARR was 18.18, PRA increased rapidly （P〈 0.01） and ARR decreased after furosemide injection. In hypertension group, before furosemide injection, ALD was （149.01±14.69）ng/L, PRA was （3.45±0.74）pg/（ml · h）, ARR was 33.45±8.87; 10 and 30 min after injection of furosemide 40mg, ALD was 176.04 and 200.06 ng/L, respectively, PRA was 7.11 and 5.68 ng/（ml · h） respec tively, ARR decreased significantly （P〈0.05）. In primary aldosteronism group, ARR was 38. 61±15.16,PRA was （3.16±0.4） ng/（ml · h）, ALD was （165. 75 ±18. 56）ng/L. After injection of 40mg furosemide, ARR was higher than before, but not statistically significant （P 〉0.05）. Conclusion After intravenous injection of 40mg furosemide, the ALD and PRA increased quickly in control and hypertension groups, the peak of PRA was at 10min and that of ALD was at 30min, but ARR decreased on the contrary. However in primary aldosteronism group, ARR was increased.

关 键 词：高血压 醛固酮增多症 呋塞米 注射 静脉内 

分 类 号：R977.7[医药卫生—药品] R972.1[医药卫生—药学]