Hasenfuss G, Holubarsch C, Herzog C, Knauf H, Spahn H, Mutschler E, Just H
Clin Cardiol. 1987 Feb;10(2):83-8. doi: 10.1002/clc.4960100203.
The influence of cardiac function on the diuretic and hemodynamic effects of the loop diuretic piretanide was investigated in nine patients with congestive heart failure. The diuretic response to piretanide correlated significantly with the pretreatment cardiac index (r = 0.90). Furthermore, a significant correlation was found between the pretreatment fractional sodium excretion and the cardiac index (r = 0.85). The fractional sodium excretion is reciprocal to the renal sodium and water reabsorption. No change in the hemodynamics was observed prior to the onset of diuresis. At 120 minutes after administration of piretanide, the reduction of mean pulmonary capillary wedge pressure (r = 0.88) and mean right atrial pressure (r = 0.80) was significantly related to the diuretic response. We conclude that the reduced diuretic response to piretanide in patients with low cardiac index is due to increased renal sodium and water reabsorption. The hemodynamic changes following the administration of piretanide are dependent on the diuresis.
在9例充血性心力衰竭患者中研究了心功能对襻利尿剂吡咯他尼的利尿和血流动力学效应的影响。吡咯他尼的利尿反应与治疗前心脏指数显著相关（r = 0.90）。此外，治疗前钠排泄分数与心脏指数之间也存在显著相关性（r = 0.85）。钠排泄分数与肾钠和水重吸收呈反比。利尿开始前未观察到血流动力学变化。给予吡咯他尼120分钟后，平均肺毛细血管楔压（r = 0.88）和平均右心房压（r = 0.80）的降低与利尿反应显著相关。我们得出结论，心脏指数低的患者对吡咯他尼的利尿反应降低是由于肾钠和水重吸收增加所致。吡咯他尼给药后的血流动力学变化取决于利尿作用。
