Applefeld J J, Kasmer R J, Hak L J, Dukes G E, Wermeling D P, McClain C J
Critical Care Services, Good Samaritan Regional Medical Center, Phoenix, AZ 85006.
Aliment Pharmacol Ther. 1994 Aug;8(4):397-402. doi: 10.1111/j.1365-2036.1994.tb00306.x.
This study evaluated the dose-response relationship of torsemide, the first pyridine-sulphonylurea loop diuretic, in patients with ascites due to cirrhosis.
During a 13-day hospitalization period, 17 patients received single, oral doses of 5 mg, 10 mg, or 20 mg of torsemide or placebo in a randomized, double-blind, crossover fashion. All the patients received a constant dose of spironolactone concomitantly beginning at least 7 days before the study. Electrolyte excretion and urine volume were measured for 24 h after each dose. Body weight was measured before, and 24 h after each dose.
Torsemide was effective in producing statistically significant, dose-related increases in urinary sodium and chloride excretion, with little effect on potassium or magnesium excretion. Urine volume increased and body weight decreased in a dose-related manner.
Torsemide increased sodium excretion substantially in patients with cirrhosis and ascites who were receiving spironolactone.
本研究评估了首个吡啶磺酰脲类袢利尿剂托拉塞米在肝硬化腹水患者中的剂量-反应关系。
在为期13天的住院期间，17例患者以随机、双盲、交叉方式接受单次口服5毫克、10毫克或20毫克托拉塞米或安慰剂。所有患者在研究开始前至少7天开始同时接受恒定剂量的螺内酯。每次给药后测量24小时的电解质排泄量和尿量。每次给药前和给药后24小时测量体重。
托拉塞米能有效使尿钠和氯排泄量产生具有统计学意义的剂量相关增加，而对钾或镁排泄影响很小。尿量增加，体重以剂量相关方式下降。
托拉塞米能使正在接受螺内酯治疗的肝硬化腹水患者的钠排泄量大幅增加。
