卡托普利对心衰患者红细胞内外钠钾及血浆地高辛浓度的影响

Effects of Captopril on Intraerythrocytic Sodium,Potassium and Plasma Digoxin Level

观察卡托普利、地高辛及联合用药治疗46例心衰患者和11例洋地黄中毒患者红细胞内钠(Na^+i)钾(K^+i)和血浆地高辛浓度。结果:卡托普利组和联合组Na^+i(x±s)为10.67±1.31和11.63±0.99mmol/L,K^+i为93.15±5.07和91.55±3.16mmol/L,与地高辛组Na^+i 12.97±0.84mmol/L、K^+i 88.80±2.32mmol/L,洋地黄中毒组Na^+i 15.63±1.97mmol/L、K^+i81.74±2.89mmol/L比较,差异有显著性意义(P<0.05或<0.01)。联合组血浆地高辛浓度比地高辛组增高。示卡托普利可避免Na^+i高、K^+i低,故可能降低洋地黄中毒发生率。与小剂量地高辛合用可达较高血浆地高辛浓度,利于慢性心衰的治疗。

The effects of combined treatment of captopril and digoxin on intraerythrocytic concentration of Na (Na+i), K(K+i) and plasma digoxin level were observed in 46 patients with CHF. 20 healthy persons and 11 patients with digoxin intoxication served as controls. 46 patients were randomly divided into digoxin group (27 cases) and captopril group (19 cases). In digoxin group, digoxin 0.125 mg qd was given for 2 weeks, and captopril of 12.5 nog tid was added for another 2 weeks. In captopril group patients received captopril 12.5 mg tid for 2 weeks.Na+i and K+i were measured in the two groups.before drug administration, 2 weeks after separate administration of either drug, and another 2 weeks after combined administration of digoxin and captopril. The results indicate that in the captopril groups and in the combined group Na+i decreased from 11.69±1.43 to 10.67±1.31 mmol/L (P<0.05). In the digoxin group Na+i rose from 11.89±1.10 to 12.97±0.84 mmol/L.while K+i dropped from 91.32±3.78 to 88.8 ±2.32 mmol/L(P<0.05). The digoxin levels in the digoxin and combined groups are all within the normal range (1.18 and 1.33 μg/L respectively), while in the intoxicated group the digoxin level is 2.0 μg/L Captopril will prevent the accumulation of Na+i and decrease of K+i, thereby preventing digitalis intoxication. The combined treatment is more beneficial to patients with chronic heart failure. It can prevent digoxin intoxication by avoiding hypo-po tassium and hyper-sodium in cells.