Allon M, Pasque C B, Rodriguez M
Nephrology Section, University of Oklahoma School of Medicine, Oklahoma City.
Am J Physiol. 1990 Aug;259(2 Pt 2):F233-8. doi: 10.1152/ajprenal.1990.259.2.F233.
Renal hemodynamics and tubular solute and water handling were evaluated in normal subjects during water diuresis, before and after the acute administration of captopril, ibuprofen, or the combination of both drugs. The glomerular filtration increased after captopril administration but did not change after ibuprofen alone or in combination with captopril. Renal plasma flow increased with captopril alone and captopril plus ibuprofen but did not change after ibuprofen alone. Urine volume and Na excretion increased with captopril and decreased after ibuprofen; coadministration of ibuprofen attenuated the tubular effects produced by captopril alone. FELi, fractional delivery of solute to the distal nephron, and FELi-FENa, fractional distal reabsorption of solute, both significantly increased after captopril and decreased after ibuprofen but did not change with the combined regimen. (FELi-FENa)/FELi, fractional reabsorption of distally delivered Na, significantly decreased after captopril and increased after ibuprofen but remained unchanged after captopril plus ibuprofen. Thus captopril and ibuprofen have opposing effects on tubular Na and water handling, which are attenuated by the addition of the other drug. This interaction may have clinical relevance in patients with heart failure or hypertension, in whom captopril is used to enhance Na and water diuresis.
在正常受试者进行水利尿期间，在急性给予卡托普利、布洛芬或两种药物联合使用之前和之后，评估了肾血流动力学以及肾小管溶质和水的处理情况。给予卡托普利后肾小球滤过增加，但单独使用布洛芬或与卡托普利联合使用后肾小球滤过无变化。单独使用卡托普利以及卡托普利加布洛芬后肾血浆流量增加，但单独使用布洛芬后肾血浆流量无变化。尿量和钠排泄量在给予卡托普利后增加，在给予布洛芬后减少；布洛芬的共同给药减弱了单独使用卡托普利产生的肾小管效应。远端肾单位溶质的分数排泄（FELi）以及溶质的分数远端重吸收（FELi - FENa）在给予卡托普利后均显著增加，在给予布洛芬后均减少，但联合用药方案下无变化。远端输送钠的分数重吸收[（FELi - FENa）/FELi]在给予卡托普利后显著降低，在给予布洛芬后增加，但在卡托普利加布洛芬后保持不变。因此，卡托普利和布洛芬对肾小管钠和水的处理具有相反的作用，而另一种药物的添加会减弱这种作用。这种相互作用在心力衰竭或高血压患者中可能具有临床相关性，在这些患者中卡托普利用于增强钠和水的利尿作用。
