不同剂量氯噻酮对血压、血钾及血尿酸的影响。
Effect of different doses of chlorthalidone on blood pressure, serum potassium, and serum urate.
作者信息
Bengtsson C, Johnsson G, Sannerstedt R, Werkö L
出版信息
Br Med J. 1975 Jan 25;1(5951):197-9. doi: 10.1136/bmj.1.5951.197.
Abstract
Chlorthalidone given to 40 hypertensive women significantly decreased blood pressure and serum potassium levels and increased the serum urate concentration. There were no individual correlations between the reduction in blood pressure and the decrease in serum potassium or the increase in serum urate. A reduction in dosage from 50 mg daily to 50 mg three times a week produced no significant changes in the diastolic or mean blood pressures though the systolic blood pressure was moderately increased. Concomitantly, serum potassium increased and serum urate decreased significantly on the lower chlorthalidone dose. We conclude that high doses of oral diuretics compared with lower ones are of limited further benefit and may increase the risk of clinically significant hypokalaemia and hyperuricaemia.
摘要
给予40名高血压女性氯噻酮后，血压和血清钾水平显著降低，血清尿酸盐浓度升高。血压降低与血清钾降低或血清尿酸盐升高之间无个体相关性。剂量从每日50毫克减至每周三次、每次50毫克后，舒张压或平均血压无显著变化，尽管收缩压有适度升高。同时，氯噻酮剂量降低时，血清钾升高，血清尿酸盐显著降低。我们得出结论，与低剂量口服利尿剂相比，高剂量口服利尿剂的进一步获益有限，且可能增加临床上显著低钾血症和高尿酸血症的风险。
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本文引用的文献
1
Uric acid retention due to hydrochlorothiazide.
N Engl J Med. 1959 Dec 31;261:1358-62. doi: 10.1056/NEJM195912312612702.
2
Treatment of arterial hypertensive disease with diuretics. I. Effects on blood pressure of bendroflumethiazide, potassium chloride, and spironolactone.用利尿剂治疗动脉高血压疾病。I. 苄氟噻嗪、氯化钾和螺内酯对血压的影响。
Arch Intern Med. 1962 Jul;110:26-33. doi: 10.1001/archinte.1962.03620190028004.
3
Effect of chlorothiazide on electrolyte transport in man; its use in the treatment of edema of congestive heart failure, nephrosis, and cirrhosis.氯噻嗪对人体电解质转运的影响；其在治疗充血性心力衰竭、肾病及肝硬化水肿中的应用。
J Am Med Assoc. 1958 Jan 11;166(2):145-52. doi: 10.1001/jama.1958.02990020033006.
4
Treatment of essential hypertension with chlorothiazide (diuril); its use alone and combined with other antihypertensive agents.
J Am Med Assoc. 1958 Jan 11;166(2):137-40. doi: 10.1001/jama.1958.02990020025004.
5
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BMQ. 1957 Sep;8(3):69-75.
6
A comparison of chlorothiazide, chlorthalidone and cyclopenthiazide in the treatment of hypertension.
Med J Aust. 1973 Jul 7;2(1):23-5. doi: 10.5694/j.1326-5377.1973.tb128609.x.
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8
The study of women in Gothenburg 1968-1969--a population study. General design, purpose and sampling results.
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9
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Lakartidningen. 1974 Aug 14;71(33):2997-3001.
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