Takamitsu Y, Yuasa S, Miki S, Yura T, Takahashi N, Uchida K, Tanaka H, Yamamoto T, Kiyomoto H, Matsuo H
Second Department of Internal Medicine, Kagawa Medical School, Osaka University.
Nihon Jinzo Gakkai Shi. 1991 Mar;33(3):295-303.
We examined the diuretic action of orally administered azosemide (AZ: 60 mg) and furosemide (FM: 40 mg) and their effects on body fluid distribution and circulatory vasoactive hormones in normal male volunteers. Urine volume and urinary sodium excretion were increased, peaking during 0 to 2 hours in FM and 2 to 4 hours in AZ in response to administration of both diuretics. The cumulative urine volume and urinary sodium excretion for 8 hours showed no significant difference between AZ and FM. Total body water (TBW) was measured by the dynamic distribution of deuterium oxide and a percentage change in circulating plasma volume (ICG ratio) was determined by using indocyanine green. The decrease in TBW and ICG ratio was detected in proportion to the increase in urine volume after administration of AZ and FM. Plasma renin activity (PRA) and plasma concentration of aldosterone (PAC), angiotensin II (ANG II) and arginine vasopressin (AVP) were elevated in response to the reduction in ICG ratio by both diuretics. The responses of PRA, PAC and ANG II to AZ were delayed about 2 hours as compared with those of FM. The increase in AVP with FM was significantly greater than that with AZ detected 2 hours after administration. The elevation of AVP in AZ was delayed and blunted compared with FM. These data indicate that the difference in diuretic property of AZ and FM may induce different stimulation to the secretion of vasoactive hormones through the changes in body fluid distribution and these hormones might modify the anti-edematic effect of AZ and FM.
我们研究了口服阿佐塞米（AZ：60毫克）和呋塞米（FM：40毫克）的利尿作用及其对正常男性志愿者体液分布和循环血管活性激素的影响。服用这两种利尿剂后，尿量和尿钠排泄量均增加，FM在0至2小时达到峰值，AZ在2至4小时达到峰值。8小时的累积尿量和尿钠排泄量在AZ和FM之间无显著差异。通过氧化氘的动态分布测量总体水（TBW），并使用吲哚菁绿测定循环血浆量的百分比变化（ICG比率）。服用AZ和FM后，TBW和ICG比率的降低与尿量的增加成比例。两种利尿剂通过降低ICG比率，使血浆肾素活性（PRA）、醛固酮（PAC）、血管紧张素II（ANG II）和精氨酸加压素（AVP）的血浆浓度升高。与FM相比，AZ对PRA、PAC和ANG II的反应延迟约2小时。服用FM后2小时检测到的AVP升高明显大于AZ。与FM相比，AZ中AVP的升高延迟且减弱。这些数据表明，AZ和FM利尿特性的差异可能通过体液分布的变化对血管活性激素的分泌产生不同的刺激，并且这些激素可能会改变AZ和FM的消肿作用。
