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双醋洛尔(一种具有β-2激动剂活性的非选择性β-肾上腺素能阻滞剂)对肾功能的影响。

Renal function effects of dilevalol, a nonselective beta-adrenergic blocking drug with beta-2 agonist activity.

作者信息

Cook M E, Wallin J D, Clifton G G, Poland M

机构信息

Department of Medicine, Tulane University School of Medicine, New Orleans, LA 70112.

出版信息

Clin Pharmacol Ther. 1988 Apr;43(4):393-9. doi: 10.1038/clpt.1988.49.

Abstract

The effects of dilevalol, a new beta-adrenergic blocking agent with beta-agonism, on renal function were determined in two groups of patients. Patients in group 1, all with normal renal function, received either dilevalol or atenolol. Patients in group II, all with impaired renal function, received either dilevalol or metoprolol. Parameters of renal function determined before and after chronic oral treatment included glomerular filtration rate (GFR), effective renal plasma flow, filtration fraction, mean arterial pressure (MAP), renal blood flow, and renal vascular resistance. Dilevalol lowered MAP by 14 mm Hg (P less than 0.005) in group I and 25 mm Hg (P less than 0.01) in group II but had no effect on other parameters of renal function, at either peak or trough drug levels. Atenolol and metoprolol also lowered MAP by 11 mm Hg (P less than 0.01) and 15 mm Hg (P less than 0.05), respectively. Atenolol reduced GFR by 23% at peak drug level, an effect that was partially ameliorated at trough drug level. The effect of atenolol on GFR appeared to vary as a function of baseline renal function in that greater reductions were seen in groups of patients with increasing baseline GFR. Metoprolol significantly decreased renal vascular resistance by 17% (P less than 0.05). These data suggest that dilevalol effectively lowers blood pressure in hypertensive patients with normal or compromised renal function with no negative impact on parameters of renal function.

摘要

在两组患者中测定了新型具有β受体激动作用的β肾上腺素能阻滞剂双醋洛尔对肾功能的影响。第一组患者肾功能均正常,他们接受双醋洛尔或阿替洛尔治疗。第二组患者肾功能均受损,他们接受双醋洛尔或美托洛尔治疗。在慢性口服治疗前后测定的肾功能参数包括肾小球滤过率(GFR)、有效肾血浆流量、滤过分数、平均动脉压(MAP)、肾血流量和肾血管阻力。双醋洛尔使第一组患者的MAP降低了14 mmHg(P<0.005),使第二组患者的MAP降低了25 mmHg(P<0.01),但在药物浓度峰值或谷值时对其他肾功能参数均无影响。阿替洛尔和美托洛尔也分别使MAP降低了11 mmHg(P<0.01)和15 mmHg(P<0.05)。阿替洛尔在药物浓度峰值时使GFR降低了23%,在药物浓度谷值时这种作用部分减轻。阿替洛尔对GFR的影响似乎随基线肾功能而变化,即基线GFR越高的患者组中降低幅度越大。美托洛尔使肾血管阻力显著降低了17%(P<0.05)。这些数据表明,双醋洛尔可有效降低肾功能正常或受损的高血压患者的血压,且对肾功能参数无负面影响。

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