Pozet N, Hadj Aissa A H, Labeeuw M, Zech P
J Pharmacol. 1983;14 Suppl 2:133-41.
Four beta-blockers: atenolol 15 mg i.v., metoprolol 25 mg i.v., acebutolol 45 mg i.v. and labetalol 50 mg i.v. were administered to 106 patients suffering from hypertension and with normal or disturbed renal function. During an identical test protocol, measurements of clearance of inulin, of PAH, urine sodium and the fraction of sodium excreted were recorded one hour before and four or five hours after administration of the antihypertensive. Mean blood pressure and heart rate were also recorded. The three pure beta-blockers reduced inulin and PAH clearance and lowered urine sodium. These modifications were the same for all three drugs. Labetalol, which also possesses alpha-blocking properties, did not reduce renal function values or urine sodium. While a slight fall in blood pressure occurred with all the antihypertensives, heart rate was reduced only by the three pure beta-blockers. The action of the four drugs was very similar whatever the state of the subject's renal function. The study of the renal effects of the beta 1-selective atenolol and metoprolol, and acebutolol which has a higher intrinsic sympathomimetic activity does not demonstrate any significantly different renal action among these three drugs, but the effects of labetalol on renal function values and urine sodium are slighter. The renal action of the beta-blockers cannot be fully explained. Though the fall in the renal plasma flow and in the glomerular filtration rate can be related partly to the decrease in the cardiac output consequent to induced bradycardia, stimulation of renal alpha-receptors must be considered.(ABSTRACT TRUNCATED AT 250 WORDS)
将15毫克静脉注射阿替洛尔、25毫克静脉注射美托洛尔、45毫克静脉注射醋丁洛尔和50毫克静脉注射拉贝洛尔这四种β受体阻滞剂给予106例患有高血压且肾功能正常或受损的患者。在相同的测试方案中,在给予抗高血压药物前1小时以及给药后4或5小时记录菊粉清除率、对氨基马尿酸清除率、尿钠及排泄钠分数的测量值。还记录了平均血压和心率。三种纯β受体阻滞剂降低了菊粉和对氨基马尿酸清除率,并降低了尿钠。这三种药物的这些改变是相同的。兼具α受体阻滞特性的拉贝洛尔并未降低肾功能值或尿钠。虽然所有抗高血压药物都使血压略有下降,但仅三种纯β受体阻滞剂降低了心率。无论受试者的肾功能状态如何,这四种药物的作用都非常相似。对β1选择性阿替洛尔、美托洛尔以及具有较高内在拟交感活性的醋丁洛尔的肾脏效应研究表明,这三种药物之间在肾脏作用方面没有显著差异,但拉贝洛尔对肾功能值和尿钠的影响较小。β受体阻滞剂的肾脏作用无法得到充分解释。虽然肾血浆流量和肾小球滤过率的下降部分可能与因诱发心动过缓导致的心输出量减少有关,但必须考虑肾脏α受体的刺激作用。(摘要截选至250词)