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新型α和β肾上腺素能受体阻断药拉贝洛尔对动脉血压、肾功能及肾素活性的影响(作者译)

[Effects of labetalol, a new alpha- and beta-adrenoreceptor blocking drug, on arterial pressure, renal function and renin activity (author's transl)].

作者信息

Zech P, Pozet N, Sassard J, Vincent M

出版信息

Nouv Presse Med. 1980 Mar 29;9(15):1087-90.

PMID:7008020
Abstract

Labetalol, a blocker of alpha- and beta-adrenoreceptors, was tried on 45 patients with severe (29 cases) or mild to moderate (16 cases) hypertension. After an initial period of dosage adjustment and a 2 months treatment in effective doses, there was a significant fall in supine blood pressure from mean values of 207/132 to 170/106 mmHg. In 23 patients hypertension was controlled by labetalol alone in doses of 400 and 1800 mg per day. True failures were rare (16%). Digestive disorders and postural hypotension were the most frequently encountered side-effects; they obliged to discontinue treatment in 4 cases, but were compatible with it in 11 cases. In 22 patients the fall in BP was accompanied by a significant (p less than 0,001) decrease in plasma renin activity from 123 to 44 ng/l/min supine and from 144 to 83 ng/l/min standing. Studies of the renal function showed no changes during oral therapy. Following intravenous injection of 50 mg labetalol to 20 subjects, inulin and PAH clearances remained unaltered, and there was a significant, though transient (1 hour), decrease in chloride, sodium and phosphorus excretion. Effective in lowering blood pressure be used and well tolerated by the kidneys, labetalol can safely be used for the treatment of severe hypertension with organic renal involvement.

摘要

拉贝洛尔是一种α和β肾上腺素能受体阻滞剂,对45例重度(29例)或轻度至中度(16例)高血压患者进行了试验。在初始剂量调整期和以有效剂量治疗2个月后,仰卧位血压从平均207/132 mmHg显著降至170/106 mmHg。23例患者仅用拉贝洛尔治疗,剂量为每日400至1800 mg,高血压得到控制。真正治疗失败的情况很少见(16%)。消化系统紊乱和体位性低血压是最常遇到的副作用;4例患者因此被迫停药,但11例患者可耐受。22例患者血压下降的同时,血浆肾素活性显著降低(p<0.001),仰卧位时从123降至44 ng/l/min,站立位时从144降至83 ng/l/min。肾功能研究显示口服治疗期间无变化。对20名受试者静脉注射50 mg拉贝洛尔后,菊粉和对氨基马尿酸清除率保持不变,氯、钠和磷排泄虽有显著但短暂(1小时)的减少。拉贝洛尔有效降低血压且肾脏耐受性良好,可安全用于治疗伴有器质性肾脏损害的重度高血压。

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