Watkins J, Abbott E C, Hensby C N, Webster J, Dollery C T
Br Med J. 1980 Sep 13;281(6242):702-5. doi: 10.1136/bmj.281.6242.702.
The effects of 100 mg indomethacin daily for three weeks on blood pressure and urinary excretion of prostaglandin F2 alpha were studied in a double-blind, placebo-controlled comparison of two groups of patients with essential hypertension, eight receiving propranolol and seven thiazide diuretics. Compared with placebo, adding indomethacin to the patients' established antihypertensive treatment increased blood pressure by 14/5 Hg supine and 16/9 mm Hg erect in the patients receiving propranolol, and by 13/9 mm Hg supine and 16/9 mm Hg erect in the patients receiving thiazide diuretics (all p less than or equal to 0.05). The excretion of the major urinary metabolite of prostaglandin F2 alpha was reduced by 67% in the propranolol-treated patients and by 57% in those receiving a thiazide diuretic. Body weight increased by 0 . 8 kg (propranolol) and 1 . 1 kg (thiazide diuretic) when indomethacin was given, but there were no significant changes in creatinine clearance, urinary sodium excretion, or packed cell volume in either treatment group. These results suggest that products formed by the arachidonic acid cyclo-oxygenase contribute to the regulation of blood pressure during treatment with both propranolol and thiazide diuretics. Inhibition of the cyclo-oxygenase with indomethacin partially antagonises the hypotensive effect of these drugs.
在一项双盲、安慰剂对照研究中，对两组原发性高血压患者进行了为期三周、每日服用100毫克消炎痛的治疗，观察其对血压及前列腺素F2α尿排泄量的影响。其中一组8名患者服用普萘洛尔，另一组7名患者服用噻嗪类利尿剂。与安慰剂相比，在患者已有的抗高血压治疗基础上加用消炎痛后，服用普萘洛尔的患者仰卧位血压升高14/5毫米汞柱，直立位升高16/9毫米汞柱；服用噻嗪类利尿剂的患者仰卧位血压升高13/9毫米汞柱，直立位升高16/9毫米汞柱（所有p值均小于或等于0.05）。前列腺素F2α主要尿代谢产物的排泄量在服用普萘洛尔的患者中降低了67%，在服用噻嗪类利尿剂的患者中降低了57%。服用消炎痛时，服用普萘洛尔的患者体重增加0.8千克，服用噻嗪类利尿剂的患者体重增加1.1千克，但两个治疗组的肌酐清除率、尿钠排泄量或红细胞压积均无显著变化。这些结果表明，花生四烯酸环氧化酶形成的产物在普萘洛尔和噻嗪类利尿剂治疗期间有助于血压调节。用消炎痛抑制环氧化酶可部分拮抗这些药物的降压作用。
