Radó J P, Gercsák G, Bános C
Int J Clin Pharmacol Ther Toxicol. 1986 Feb;24(2):69-76.
The effect of angiotensin converting enzyme inhibition by captopril (CAP) on serum potassium (SK) changes was studied during a three-hour glucose tolerance test (GTT) in recumbent and upright positions in 16 patients with drug-resistant hypertension. An elevation of SK in the upright posture occurred in the course of GTT during CAP treatment in 50% of the patients (Group I) even without consistent changes in baseline SK. In Group II a qualitatively normal glucose-induced hypokalemic response was obtained. Aldosterone was suppressed by CAP, predominantly in the upright position in Group I due to the significant interaction between the drug and posture. Significant inverse correlations were found in Group I between glucose-induced serum potassium changes and basal glomerular filtration rate. A similar correlation was found also with serum insulin in the whole patient material. It was concluded that the interplay of various factors, CAP, upright posture and impaired renal functions resulting in suppression of aldosterone and insulin played a role in the paradoxical glucose-induced serum potassium elevation.
在16例顽固性高血压患者中，研究了卡托普利（CAP）抑制血管紧张素转换酶对卧位和立位三小时葡萄糖耐量试验（GTT）期间血清钾（SK）变化的影响。在CAP治疗期间，50%的患者（第一组）在GTT过程中立位时SK升高，即使基线SK无持续变化。第二组获得了定性正常的葡萄糖诱导的低钾反应。CAP抑制了醛固酮，在第一组中主要是立位时，这是由于药物与体位之间的显著相互作用。第一组中发现葡萄糖诱导的血清钾变化与基础肾小球滤过率之间存在显著负相关。在整个患者群体中，血清胰岛素也发现了类似的相关性。得出的结论是，各种因素（CAP、立位姿势和导致醛固酮和胰岛素抑制的肾功能受损）之间的相互作用在葡萄糖诱导的血清钾反常升高中起了作用。
