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目的 :探讨培哚普利对慢性充血性心力衰竭 (CCHF)病人血清地高辛和肾功能的影响。方法 :32例心功能Ⅲ～Ⅳ级的CCHF病人给地高辛0 .2 5mg ,po ,qd× 1wk ,继而地高辛剂量改为 0 .12 5～ 0 .2 5mg ,po ,qd× 4wk ;给地高辛wk 1末后开始给培哚普利 2～ 4mg ,po ,qd× 4wk。结果 :培哚普利治疗前、治疗wk 2末和wk 4末其血清地高辛浓度分别为 ( 1.14±s 0 .13) ,( 1.2 3± 0 .0 6)和 ( 1.2 3±0 .12 )nmol·L- 1,治疗前后差异无显著意义 (P >0 .0 5) ;血钾上升 ,但在正常范围 ;血尿素氮、肌酐、尿酸和 β2 微球蛋白均略有下降 ,纠正肌酐清除率至wk 4末有显著升高 (P <0 .0 1)。结论 :培哚普利能改善CCHF病人的肾功能 ,不增加地高辛的浓度
Objective: To investigate the effect of perindopril on serum digoxin and renal function in patients with chronic congestive heart failure (CCHF). Methods: 32 patients with cardiac function Ⅲ ~ Ⅳ grade CCHF patients were given digoxin 0. 25mg, po, qd × 1wk, then digoxin dose was changed to 0.12 5 ~ 0. 25mg, po, qd × 4wk ; To digoxin wk 1 to the end of perindopril 2 ~ 4mg, po, qd × 4wk. Results: Serum digoxin concentrations at the end of wk 2 and wk 4 were (1.14 ± s 0 .13), (1.2 3 ± 0. 06) and (1.2 3 ± 0. 12) nmol·L-1, there was no significant difference between before and after treatment (P> 0.05); serum potassium increased but in the normal range; blood urea nitrogen, creatinine, uric acid and β2 microglobulin decreased slightly, Creatinine clearance was significantly higher at the end of wk 4 (P <0.01). CONCLUSION: Perindopril improves renal function in CCHF patients without increasing the concentration of digoxin