CARRUTHERS B M, LEDRAY R D, SERAGLIA M, MCINTOSH H W, WALSH G C
Can Med Assoc J. 1963 Sep 28;89(13):633-41.
Spironolactone was evaluated as a diuretic in the therapy of six patients with chronic severe congestive heart failure, during which metabolic balance studies were performed. Two of the patients showed a clear-cut although moderate diuresis and natriuresis in response to spironolactone in the presence of other diuretics. Two patients had slight unsustained responses and two showed no response. No significant change in potassium excretion was observed. A decrease in the serum sodium level was noted in four patients, associated with a rise in serum potassium. Urinary aldosterone excretion was normal or low in all patients and showed no correlation with the diuretic response to spironolactone.It is concluded that spironolactone has definite but limited usefulness in the therapy of some but not all patients with chronic congestive heart failure.
在对6例慢性重度充血性心力衰竭患者进行治疗期间，对螺内酯作为利尿剂进行了评估，并在此过程中进行了代谢平衡研究。在同时使用其他利尿剂的情况下，有2例患者对螺内酯有明显但适度的利尿和利钠反应。2例患者有轻微的、持续时间短的反应，2例患者无反应。未观察到钾排泄有显著变化。4例患者血清钠水平降低，同时血清钾升高。所有患者尿醛固酮排泄正常或降低，且与对螺内酯的利尿反应无关。得出的结论是，螺内酯在治疗部分而非全部慢性充血性心力衰竭患者中有一定但有限的作用。
