乙酰水杨酸对慢性肾功能不全患者的急性影响。

Acute effects of acetylsalicylic acid in patients with chronic renal insufficiency.

作者信息

Berg K J

出版信息

Eur J Clin Pharmacol. 1977 Jan 3;11(2):111-6. doi: 10.1007/BF00562901.

Abstract

The effect of acetylsalicylic acid (ASA) in patients with renal insufficiency has been examined. In one investigation (A), in patients with a mean GFR of 23.0 ml/min the acute effects of ASA 750 mg i.v. (lysine-ASA 7.5 ml) and 0.9% NaCl 7.5 ml on renal water and solute output and on the clearance of inulin, creatinine and PAH were compared. In another (B) the effects of simultaneous administration of ASA 750 mg or 0.9% NaCl 7.5 ml i.v. with an infusion of furosemide 250 mg were investigated in six patients (mean GFR 12.9 ml/min) in a cross-over study. In study A there was a significant fall in urinary sodium excretion within the first 15 min after ASA administration, with a maximal decrease to 21% of the control period. Urine flow fell to 35%, osmolal clearance to 41%, inulin clearance to 54% and PAH clearance reabsorption of sodium increased. The effect of ASA lasted for 2-6 h. The mean salicylic acid concentration during the first two hours after ASA administration was 60.0 mug/ml, and the mean protein bound salicylic acid (SA) was 70.4%. There was no effect of placebo (0.9% NaCl 7.5 ml) on renal function. Pretreatment with ALA 750 mg i.v. attenuated the diuretic effect of furosemide 250 mg, and reduced creatinine clearance significantly within 0-2 h after drug administration.

摘要

已对乙酰水杨酸（ASA）在肾功能不全患者中的作用进行了研究。在一项调查（A）中，对平均肾小球滤过率（GFR）为23.0 ml/min的患者，比较了静脉注射750 mg ASA（赖氨酸 - ASA 7.5 ml）和7.5 ml 0.9%氯化钠对肾脏水和溶质排出量以及菊粉、肌酐和对氨基马尿酸清除率的急性影响。在另一项调查（B）中，在一项交叉研究中，对6名患者（平均GFR 12.9 ml/min）研究了静脉注射750 mg ASA或7.5 ml 0.9%氯化钠与250 mg呋塞米输注同时给药的效果。在研究A中，ASA给药后前15分钟内尿钠排泄显著下降，最大降幅降至对照期的21%。尿流量降至35%，渗透清除率降至41%，菊粉清除率降至54%，对氨基马尿酸清除率钠重吸收增加。ASA的作用持续2 - 6小时。ASA给药后前两小时水杨酸平均浓度为60.0 μg/ml，蛋白结合水杨酸（SA）平均为70.4%。安慰剂（7.5 ml 0.9%氯化钠）对肾功能无影响。静脉注射750 mg ALA预处理减弱了250 mg呋塞米的利尿作用，并在给药后0 - 2小时内显著降低了肌酐清除率。