Dzau V J, Hollenberg N K
Ann Intern Med. 1984 Jun;100(6):777-82. doi: 10.7326/0003-4819-100-6-777.
To assess the effect of furosemide and captopril on renal function and hyponatremia in patients with severe heart failure, we studied two groups of patients with hyponatremia who were receiving digoxin therapy and whose sodium intake was 40 meq/d. One group received captopril and furosemide, the second received captopril. The first group responded to combination therapy with a brisk natriuresis and diuresis, weight reduction, and an increase in serum sodium concentration. Patients who received captopril alone did not respond, despite a similar increase in renal plasma flow and glomerular filtration rate. When furosemide was then administered to patients who had received captopril alone, a brisk natriuresis, weight loss, and correction of hyponatremia followed. Treatment with furosemide is necessary to promote natriuresis and correction of hyponatremia in patients with severe heart failure treated with captopril; the renal vascular action of captopril enhances the effectiveness of furosemide.
为评估速尿和卡托普利对重度心力衰竭患者肾功能及低钠血症的影响，我们研究了两组接受地高辛治疗且钠摄入量为40meq/d的低钠血症患者。一组接受卡托普利和速尿，另一组接受卡托普利。第一组对联合治疗反应迅速，出现明显的利钠和利尿、体重减轻以及血清钠浓度升高。单独接受卡托普利治疗的患者无反应，尽管肾血浆流量和肾小球滤过率有类似升高。当对单独接受卡托普利治疗的患者给予速尿后，出现了明显的利钠、体重减轻和低钠血症的纠正。在用卡托普利治疗的重度心力衰竭患者中，使用速尿治疗对于促进利钠和纠正低钠血症是必要的；卡托普利的肾血管作用增强了速尿的疗效。
