Cleland J G, Dargie H J, Pettigrew A, Gillen G, Robertson J I
Am Heart J. 1986 Jul;112(1):130-5. doi: 10.1016/0002-8703(86)90690-3.
The effect of captopril as long-term treatment in 20 patients with congestive heart failure has been studied in a double-blind trial. Captopril caused a significant increase in serum digoxin levels. No patients developed evidence of digoxin toxicity. Serum and total body potassium rose and the frequency of ventricular arrhythmias showed a modest decline. Creatinine clearance and radioisotopically measured glomerular filtration rate fell, but there was a poor relationship between these and the increase in serum digoxin. In a further open study on 12 patients, creatinine, urea, and digoxin clearance were significantly reduced by captopril. However, digoxin clearance declined more than creatinine clearance (89 +/- 25 mumol/L to 69 +/- 22 mumol/L and 81 +/- 14 mumol/L to 72 +/- 19 mumol/L, respectively, p less than 0.05 for the difference). Fractional excretion of urea and digoxin filtered at the glomerulus declined, indicating greater tubular reabsorption or reduced tubular secretion of these compounds. Captopril causes an increase in serum digoxin by reducing renal clearance of the drug.
在一项双盲试验中，研究了卡托普利对20例充血性心力衰竭患者的长期治疗效果。卡托普利使血清地高辛水平显著升高。没有患者出现地高辛毒性的证据。血清和全身钾水平升高，室性心律失常的发生率略有下降。肌酐清除率和放射性同位素测定的肾小球滤过率下降，但这些与血清地高辛升高之间的关系不大。在另一项针对12例患者的开放性研究中，卡托普利使肌酐、尿素和地高辛清除率显著降低。然而，地高辛清除率的下降幅度大于肌酐清除率（分别从89±25μmol/L降至69±22μmol/L和从81±14μmol/L降至72±19μmol/L，差异p<0.05）。肾小球滤过的尿素和地高辛的分数排泄下降，表明这些化合物的肾小管重吸收增加或肾小管分泌减少。卡托普利通过降低药物的肾脏清除率导致血清地高辛升高。
