Bevegård S, Castenfors J, Danielson M, Bergström J
Acta Med Scand. 1977;202(5):379-84. doi: 10.1111/j.0954-6820.1977.tb16847.x.
Muscle content of water and electrolytes (needle biopsy), intraarterial BP and cardiac output (dye dilution technique) were measured in 12 patients with essential hypertension before and after 4 months of mefruside therapy (25 mg/day). Before therapy there were no significant differences in muscle tissue electrolyte and water content compared with normotensive subjects. No correlation was found between central hemodynamic variables and the electrolyte and water content of muscle tissue either before or after therapy. After 4 months of mefruside therapy, muscle tissue water showed a mean decrease which was not significant. Serum potassium and muscle potassium content decreased significantly but there was no significant change in intracellular potassium concentration. Intracellular sodium concentration increased significantly, while muscle sodium content showed a mean increase which was not statistically significant. The change in intracellular sodium concentration showed a significant negative correlation with the decrease in mean arterial BP. The change in total cellular water content showed a significant negative correlation to the changes in total peripheral vascular resistance. Saluretic therapy seems to induce counterregulatory mechanisms that interfere with the hypotensive effect.
对12例原发性高血压患者在服用美夫西特治疗(25毫克/天)4个月前后,测量其肌肉的水和电解质含量(针吸活检)、动脉内血压及心输出量(染料稀释技术)。治疗前,与血压正常者相比,肌肉组织电解质和水含量无显著差异。治疗前后,均未发现中心血流动力学变量与肌肉组织电解质和水含量之间存在相关性。服用美夫西特治疗4个月后,肌肉组织水分平均减少,但不显著。血清钾和肌肉钾含量显著降低,但细胞内钾浓度无显著变化。细胞内钠浓度显著升高,而肌肉钠含量平均升高,但无统计学意义。细胞内钠浓度的变化与平均动脉压的降低呈显著负相关。细胞总含水量的变化与总外周血管阻力的变化呈显著负相关。利钠利尿疗法似乎会诱导反调节机制,从而干扰降压效果。