摘要
目的 :观察氯沙坦及卡托普利对心功能不全患者血清地高辛浓度及疗效的影响。方法 :2 8例心功能Ⅱ～Ⅳ级的充血性心力衰竭患者每天口服地高辛 0 .2 5mg ,1wk后当血清地高辛浓度达稳态后 ,随机分为氯沙坦组和卡托普利组。氯沙坦组加服氯沙坦 5 0mg ,qdⅹ 4wk ;卡托普利组加服卡托普利2 5mg ,tidⅹ 4wk。于合用前及合用后第 1周、第 4周测定血清地高辛浓度 ,并观察临床疗效。结果 :氯沙坦并不增加地高辛稳态血清浓度 ,卡托普利增加地高辛稳态血清浓度 2 9.6 % ;两药均可增加左室射血分数 ,减慢心率 ,降低血压 ,总有效率分别为92 .9%、85 .7% ,对血钾、血肌酐无明显影响 ,氯沙坦组耐受性高于卡托普利组。结论 :氯沙坦与地高辛联合应用治疗心功能不全患者是安全的 ,并能改善患者心脏功能 ,其耐受性优于卡托普利 ;卡托普利与地高辛联合应用时应密切监测血清地高辛浓度。
AIM: To observe the effects of angiotensin receptor antagonist losartan and angi otensin converting enzyme inhibitor captopril on serum digoxin concentrations an d clinical efficacy in the patients with heart failure. METHODS: Twenty-eight patients with NYHA class Ⅱ-Ⅳ heart failure were randomly assig ned to losartan group and captopril group,were treated with digoxin 0.25 mg (po, qd) for 1 wk. And then followed by 4wk combination with lo sartan ( 50 mg , po, qd) or captopril ( 25 mg , po, tid). The serum digoxin concentrations and clinical features were monit ored and measured. RESULTS: Losartan did not increase the steady state level of serum digoxin, but captopril could increase serum digoxin concen trations by 29.6 %; both groups had the effects of increasing LVEF, reducing heart rate, decreasing blood pressure, the total clinical effective rates of los artan group and captopril group were 92.9 % and 85.7 %, respectively. The serum potassium and creatinine were unchanged. The compliance in losartan group was better than that in captopril group. CONCLUSION: Both losart an and captopril were effective in treatment of patients with heart failure. The co-administration of digoxin with losartan was safe. The digoxin concentration s should be monitored in combination with captopril.
出处
《中国临床药理学与治疗学》
CAS
CSCD
2003年第6期655-658,共4页
Chinese Journal of Clinical Pharmacology and Therapeutics
关键词
药效学
氯沙坦
卡托普利
地高辛
心功能不全
血清浓度
pharmacodynamics
losartan
captopril
digoxin
serum concent ration
heart failure
