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在健康受试者和高血压患者中进行的莫唑胺临床试验:药物作用的新视角

Clinical trial with muzolimine in healthy and hypertensive subjects: new vistas on the drug action.

作者信息

Bernardi P, Bastagli L, Cavazza M, Minelli C, Ventura C, Fontana F, Danieli A, Bartolini G, Tommasi V, Orlandi M

机构信息

Medical Clinic II, S. Orsola Hospital, Bologna, Italy.

出版信息

Int J Clin Pharmacol Res. 1987;7(6):455-61.

PMID:3126155
Abstract

The mechanism of muzolimine (3-amino-1-[3,4-dichloro-alpha-methyl-benzyl]-2 pyrazolin-5-one) action is still not completely defined. The identified site of action is the Henle loop, similarly to furosemide which acts also by mediating renal prostaglandin synthesis. The aim of the present study was to evaluate the early effects of muzolimine (30 mg per os) on renal function and prostaglandin urinary excretion in healthy controls and hypertensive subjects. Urinary flow reached the peak values by the third hour after the drug and a diuretic effect not directly dependent on glomerular filtration was observed, especially in hypertensive patients. In these cases the diuresis increased also due to a low glomerular filtration rate and tubular phenomena were more evident than in controls: an increasing Na+ tubular excretion and a parallel decreasing % Na+ reabsorption. Blood pressure was not significantly influenced by muzolimine in healthy subjects, while it returned to normal values in the hypertensive group. A cyclooxigenase inhibitor, lysine acetylsalicylate (1 g i.m.) administered 10 minutes after muzolimine, was not able to modify the parameters under consideration. Therefore a mediation by prostaglandins on the diuretic and antihypertensive effects of the drug under study may probably be excluded.

摘要

莫唑胺(3-氨基-1-[3,4-二氯-α-甲基苄基]-2-吡唑啉-5-酮)的作用机制尚未完全明确。已确定其作用部位是髓袢升支粗段,这与呋塞米类似,后者也是通过介导肾前列腺素合成发挥作用。本研究的目的是评估莫唑胺(口服30毫克)对健康对照者和高血压患者肾功能及前列腺素尿排泄的早期影响。用药后第三小时尿流量达到峰值,且观察到一种不直接依赖肾小球滤过的利尿作用,尤其在高血压患者中更为明显。在这些病例中,由于肾小球滤过率降低,尿量也增加,且肾小管现象比对照组更明显:肾小管钠排泄增加,同时钠重吸收百分比平行下降。莫唑胺对健康受试者的血压无显著影响,而在高血压组中血压恢复到正常水平。在莫唑胺给药10分钟后给予环氧化酶抑制剂赖氨酸乙酰水杨酸(1克,肌肉注射),未能改变所研究的参数。因此,前列腺素对所研究药物的利尿和降压作用的介导作用可能可以排除。

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