Esch I, Placheta P, Gaul G
Wien Klin Wochenschr. 1976 Jun 25;88(13):415-8.
In an acute clinical trial 12 patients with essential hypertension on a standardized sodium and potassium dietary intake were given either amilorid (10 mg daily, orally) or potassium canrenoate (200 mg daily, i.v.) for two days. Either treatment caused a significant decrease in blood pressure and an increase in plasma renin activity (PRA). The aldosterone excretion rate was elevated only in the patients receiving amilorid. Furthermore potassium retention and sodium loss were more pronounced in the amilorid group. Long-term treatment (up to 14 weeks) with amilorid (10 mg daily), spironolactone (200 mg daily) or chlortalidone (50 mg daily) significantly lowered the blood pressure of patients with essential hypertension. Plasma potassium and PRA rose significantly in patients receiving either amilorid or spironolactone. However, after three weeks of therapy the mean PRA returned to the pretreatment level in patients on amilorid while it remained persistently elevated in the spironolactone group. On the other hand, chlortalidone caused potassium loss and persistent elevation of PRA. A possible relationship between the changes in plasma potassium levels and PRA in response to diuretics is discussed.
在一项急性临床试验中，12名原发性高血压患者在标准化钠钾饮食摄入情况下，接受了为期两天的氨氯吡咪（每日10毫克，口服）或坎利酸钾（每日200毫克，静脉注射）治疗。两种治疗方法均导致血压显著下降，血浆肾素活性（PRA）升高。仅在接受氨氯吡咪治疗的患者中醛固酮排泄率升高。此外，氨氯吡咪组的钾潴留和钠丢失更为明显。用氨氯吡咪（每日10毫克）、螺内酯（每日200毫克）或氯噻酮（每日50毫克）进行长期治疗（长达14周）可显著降低原发性高血压患者的血压。接受氨氯吡咪或螺内酯治疗的患者血浆钾和PRA显著升高。然而，治疗三周后，服用氨氯吡咪的患者平均PRA恢复到治疗前水平，而在螺内酯组中仍持续升高。另一方面，氯噻酮导致钾丢失和PRA持续升高。文中讨论了利尿剂引起的血浆钾水平变化与PRA之间的可能关系。
