Vinogradov A V, Sycheva I M, Zhuravleva I A
Kardiologiia. 1975 Oct;15(10):46-52.
The antipyrine and thiosulphate spaces were measured in patients with circulatory insufficiency of the II B and III stages before and after medication with cardiac glycosides and diuretics, used in various combinations and in courses of different duration and also in 2-week long courses of treatment with ethacrine acid and aldactone in order to study the nature of changes in the water-electrolyte exchange in cardiac insufficiency following diminution of edemas occurring under the effect of an effective therapy. The main indication of cardiac insufficiency, the expansion of the extracellular space, was found to continue even after a clinically effective treatment and complete disappearance of edemas. When myocardial contractility continues to be at a low level and the aldosterone activity is high--the removal from the organism of a large quantity of fluid with the help of diuretics, while reducing the external clinical manifestations of the edematous conditions, aggravates at the same time the pathological nature of the fluid distribution between the extracellular medium and the cells, this being due, in the main, to the reduction in the amount of fluid in the cells. The differences between ethacrine acid and aldactone find their expression not only in a greater of smaller effectiveness of their diuretic action, but also in the influence which they exert on the regulation of water metabolism in cardiac insufficiency.
在II B期和III期循环功能不全患者中，在使用不同组合、不同疗程的强心苷和利尿剂药物治疗前后，以及在使用依他尼酸和安体舒通进行为期2周的治疗过程中，测量安替比林和硫代硫酸盐间隙，以便研究在有效治疗使水肿减轻后，心功能不全时水电解质交换变化的性质。发现即使在临床有效治疗且水肿完全消失后，心功能不全的主要指征——细胞外间隙扩大仍会持续。当心肌收缩力持续处于低水平且醛固酮活性较高时，借助利尿剂从机体排出大量液体，虽能减轻水肿的外部临床表现，但同时会加剧细胞外介质与细胞间液体分布的病理性质，这主要是由于细胞内液体量减少所致。依他尼酸和安体舒通之间的差异不仅体现在利尿作用效果的大小上，还体现在它们对心功能不全时水代谢调节的影响上。
