Wu K D, Hsieh B S, Tsai H F, Chen Y M, Chu T S
Department of Internal Medicine, National Taiwan University Hospital, Taipei, Republic of China.
Clin Exp Hypertens A. 1990;12(8):1395-403. doi: 10.3109/10641969009073526.
Acute responses of blood pressure and natriuresis to intravenous injection of furosemide and saline infusion were evaluated in 38 patients with essential hypertension. Twelve patients whose mean arterial blood pressure decreased by more than 5% at two hours after intravenous administration of 20 mg furosemide were classified as salt-sensitive (SS); the remainders as salt-resistant (SR). The extent of natriuresis induced by furosemide was not different between the two subgroups. During 2-liter isotonic saline infusion the SS subjects excreted more sodium than the SR subjects did (108.7 +/- 11.9 vs 55.9 +/- 6.6 mmole, p less than 0.001). There was a significant correlation (r = 0.57, p less than 0.001) between the hypotensive effect of furosemide and the 4-hour sodium excretion during saline infusion. A reverse correlation between the sodium excretion during saline infusion and the increase in mean blood pressure at the end of infusion was shown in the SS subgroup (r = -0.72, p less than 0.01), but not in the SR subgroup (r = 0.045). The results suggest that prompt natriuresis on saline infusion in the SS hypertensives may function as a protective mechanism to prevent abrupt increase in blood volume and blood pressure during acute sodium loading.
对38例原发性高血压患者静脉注射速尿和输注生理盐水后血压和利钠作用的急性反应进行了评估。12例患者在静脉注射20mg速尿两小时后平均动脉血压下降超过5%，被归类为盐敏感型（SS）；其余患者为盐抵抗型（SR）。速尿诱导的利钠程度在两个亚组之间没有差异。在输注2升等渗盐水期间，SS组患者排出的钠比SR组患者多（108.7±11.9对55.9±6.6毫摩尔，p<0.001）。速尿的降压作用与输注盐水期间4小时的钠排泄量之间存在显著相关性（r=0.57，p<0.001）。SS亚组显示输注盐水期间的钠排泄与输注结束时平均血压升高呈负相关（r=-0.72，p<0.01），而SR亚组则无此相关性（r=0.045）。结果表明，SS型高血压患者输注盐水后迅速利钠可能起到一种保护机制的作用，以防止急性钠负荷期间血容量和血压突然升高。
