Clifton G, McMahon G, Ryan J, Vargas R, Bekele T, Wallin D
Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112.
Clin Pharmacol Ther. 1989 Jan;45(1):85-91. doi: 10.1038/clpt.1989.13.
Enoximone is an investigational cardiotonic agent with positive inotropic and vasodilatory properties. In this protocol the effects of enoximone on parameters of renal function in patients (n = 14) with New York Heart Association class II or III congestive heart failure were determined after intravenous (IV) treatment (2 mg/kg) and after chronic oral administration (150 mg t.i.d.), either alone or with added furosemide (40 mg b.i.d.). Glomerular filtration rate (GFR), effective renal plasma flow (ERPF), filtration fraction, mean arterial pressure (MAP), renal blood flow (RBF), and renal vascular resistance (RVR) were determined each time. Plasma volume (PV) was determined at baseline and after oral enoximone and after oral enoximone plus furosemide. Significant reductions in GFR (18%) and ERPF (20%) were observed after IV treatment but not after oral treatment with or without furosemide. MAP also was lowered significantly by 14% after IV administration but not after oral treatments. PV after oral enoximone plus furosemide was reduced significantly (31%) compared with baseline. These results demonstrate that enoximone produces acute reductions in GFR and ERPF when given intravenously but has no effect on parameters of renal function when given orally, either alone or with furosemide.
依诺昔酮是一种具有正性肌力和血管舒张特性的研究性强心剂。在本研究方案中,对14例纽约心脏病协会II级或III级充血性心力衰竭患者静脉注射(2mg/kg)和长期口服(150mg每日三次)依诺昔酮后,单独使用或加用呋塞米(40mg每日两次),测定依诺昔酮对肾功能参数的影响。每次均测定肾小球滤过率(GFR)、有效肾血浆流量(ERPF)、滤过分数、平均动脉压(MAP)、肾血流量(RBF)和肾血管阻力(RVR)。在基线、口服依诺昔酮后以及口服依诺昔酮加呋塞米后测定血浆容量(PV)。静脉注射后观察到GFR(18%)和ERPF(20%)显著降低,但口服治疗(无论是否加用呋塞米)后未观察到这种情况。静脉给药后MAP也显著降低14%,但口服治疗后未出现这种情况。与基线相比,口服依诺昔酮加呋塞米后的PV显著降低(31%)。这些结果表明,依诺昔酮静脉给药时会使GFR和ERPF急性降低,但口服给药时(单独使用或与呋塞米合用)对肾功能参数无影响。