Juhlin Tord, Jönsson Bo A G, Höglund Peter
Department of Cardiology, Malmö University Hospital, Malmö, Sweden.
Eur J Heart Fail. 2008 Sep;10(9):892-8. doi: 10.1016/j.ejheart.2008.06.014.
High doses of aspirin counteract the beneficial effects of angiotensin-converting enzyme (ACE) inhibitors. It is not known how low-dose aspirin, with concomitant ACE-inhibitor treatment, affects renal function.
To study renal effects of different doses of aspirin in elderly healthy volunteers who had an activated renin-angiotensin system.
Sixteen subjects each received two different doses of aspirin (0 and160 mg or 80 and 320 mg) after pre-treatment with bendroflumethiazide and enalapril, in a randomised double-blind, cross-over fashion.
Least square means of the observations 30 to 180 min after dosing, showed that urine flow, GFR, excretion rates of sodium, osmolality clearance and free water clearance were significantly decreased in a dose-dependent manner. Urine flow, sodium excretion rate and free water clearance were significantly lower with 320 mg aspirin vs. 0 mg and 80 mg, and GFR was significantly lower with 320 mg vs. 80 mg. Urine flow, sodium excretion rate, free water and osmolality clearance was significantly lower with aspirin 160 mg vs. 0 mg.
The dose-dependent renal effects of aspirin are of clinical importance from a dose of 160 mg. The adverse influence of aspirin doses higher than 80 mg should be taken into consideration in patients with heart failure.
高剂量阿司匹林会抵消血管紧张素转换酶（ACE）抑制剂的有益作用。目前尚不清楚低剂量阿司匹林与ACE抑制剂联合治疗时如何影响肾功能。
研究不同剂量阿司匹林对肾素 - 血管紧张素系统激活的老年健康志愿者肾功能的影响。
16名受试者在接受苄氟噻嗪和依那普利预处理后，以随机双盲交叉方式分别接受两种不同剂量的阿司匹林（0和160mg或80和320mg）。
给药后30至180分钟观察结果的最小二乘均值显示，尿流量、肾小球滤过率（GFR）、钠排泄率、渗透清除率和自由水清除率均呈剂量依赖性显著降低。与0mg和80mg相比，320mg阿司匹林组的尿流量、钠排泄率和自由水清除率显著更低，与80mg相比，320mg组的GFR显著更低。与0mg相比，160mg阿司匹林组的尿流量、钠排泄率、自由水和渗透清除率显著更低。
从160mg剂量起，阿司匹林的剂量依赖性肾脏效应具有临床重要性。心力衰竭患者应考虑高于80mg剂量阿司匹林的不良影响。
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