Pritchard G, Lyons D, Webster J, Petrie J C, MacDonald T M
Clinical Pharmacology Unit, University of Aberdeen, Foresterhill, UK.
Br J Clin Pharmacol. 1997 Aug;44(2):145-9. doi: 10.1046/j.1365-2125.1997.00632.x.
To assess the effect of trandolapril (2 mg once daily) and indomethacin (25 mg three times daily), alone and in combination, on renal function and renal functional reserve in hypertensive patients (DBP 95-115 mmHg) requiring regular non-steroidal anti-inflammatory drugs (NSAIDs).
Randomized, double-blind, placebo-controlled, four way crossover design. After 3 weeks treatment renal plasma flow (RPF) and glomerular filtration rate (GFR) were measured using the p-aminohippurate (PAH) and inulin methods. Renal functional reserve was estimated by measuring RPF and GFR at the end of an intravenous infusion of dopamine 2 microg kg(-1) and 10% amino acid solution.
There was no significant difference in RPF between treatments: -22.79 ml min(-1) (95% CI -54.82, 9.24) for placebo and trandolapril, -10.37 ml min(-1) (95% CI -30.7, 9.96) for placebo and indomethacin, -14.78 ml min(-1) (95% CI -50.33, 20.77) for placebo and trandolapril with indomethacin. There was no significant difference in functional reserve RPF between treatments: -34.96 ml min(-1) (95% CI -119.8, 49.88) for placebo and trandolapril, 29.78 ml min(-1), -15.18, 74.74) for placebo and indomethacin, and -25.84 ml min(-1) (95% CI -87.62, 35.94) for placebo and trandolapril with indomethacin. There was no significant difference in GFR between treatments: -1.01 ml min(-1) (95% CI -7.45, 5.42) for placebo and trandolapril, -7.88 ml min(-1) (95% CI -15.08, -0.68) for placebo and indomethacin, and -0.36 ml min(-1) (95% CI -7.58, 6.86) for placebo and trandolapril with indomethacin. There was no significant difference in functional reserve GFR between treatments: 5.13 ml min(-1) (95% CI -4.97, 15.23) for placebo and trandolapril, 6.31 ml min(-1) (95% CI -1.88, 14.5) for placebo and indomethacin, 7.21 ml min(-1) (95% CI 1.26, 13.16) for placebo and trandolapril with indomethacin.
In hypertensives chronic treatment with NSAIDs or ACEI alone or in combination did not change RPF or GFR and did not change renal functional reserve capacity of RPF or GFR.
评估群多普利（每日一次，每次2毫克）和吲哚美辛（每日三次，每次25毫克）单独及联合使用，对需要定期服用非甾体抗炎药（NSAIDs）的高血压患者（舒张压95 - 115 mmHg）肾功能和肾功储备的影响。
随机、双盲、安慰剂对照、四交叉试验设计。治疗3周后，采用对氨基马尿酸（PAH）法和菊粉法测量肾血浆流量（RPF）和肾小球滤过率（GFR）。通过在静脉输注多巴胺2微克/千克（-1）和10%氨基酸溶液结束时测量RPF和GFR来评估肾功储备。
各治疗组间RPF无显著差异：安慰剂与群多普利组为-22.79毫升/分钟（95%可信区间-54.82，9.24）；安慰剂与吲哚美辛组为-10.37毫升/分钟（95%可信区间-30.7，9.96）；安慰剂与群多普利联合吲哚美辛组为-14.78毫升/分钟（95%可信区间-50.33，20.77）。各治疗组间肾功储备RPF无显著差异：安慰剂与群多普利组为-34.96毫升/分钟（95%可信区间-119.8，49.88）；安慰剂与吲哚美辛组为29.78毫升/分钟，-15.18，74.74；安慰剂与群多普利联合吲哚美辛组为-25.84毫升/分钟（95%可信区间-87.62，35.94）。各治疗组间GFR无显著差异：安慰剂与群多普利组为-1.01毫升/分钟（95%可信区间-7.45，5.42）；安慰剂与吲哚美辛组为-7.88毫升/分钟（95%可信区间-15.08，-0.68）；安慰剂与群多普利联合吲哚美辛组为-0.36毫升/分钟（95%可信区间-7.58，6.86）。各治疗组间肾功储备GFR无显著差异：安慰剂与群多普利组为5.13毫升/分钟（95%可信区间-4.97，15.23）；安慰剂与吲哚美辛组为6.31毫升/分钟（95%可信区间-1.88，14.5）；安慰剂与群多普利联合吲哚美辛组为7.21毫升/分钟（95%可信区间1.26，13.16）。
在高血压患者中，单独或联合使用NSAIDs或ACEI进行长期治疗，不会改变RPF或GFR，也不会改变RPF或GFR的肾功储备能力。
