尼群地平、卡托普利对充血性心力衰竭患者血清地高辛浓度的影响及其疗效比较

Effects of nitrendipine and captopril on serum digoxin concentration in patients with congestive heart failure and their comparison of efficacies

２２例心力衰竭患者随机分为尼群地平组１２例和卡托普利组１０例，服地高辛０．２５ｍｇ，ｑｄ，１０ｄ后，合用尼群地平（１０ｍｇ，ｐｏ，ｂｉｄ）或卡托普利（２５ｍｇ，ｐｏ，ｔｉｄ）１４ｄ，合用药前后取血、留尿，放射免疫法测定其中地高辛浓度并作心功能检查。结果：卡托普利使血清地高辛浓度（ＳＤＣ）降低１９％（Ｐ＜０．０５）、肾地高辛清除率（Ｃｌｄｉｇ）增加３５％（Ｐ＜０．０１），而尼群地平对它们无明显影响，但显著改善心功能，疗效不比卡托普利差。

Twenty-two patients with severe congestive heart failure were randomly assigned to receive either nitrendipine(n=12,10 mg,po,bid)or captopril(n=10,25 mg,po,tid).The patients received digoxin 0.25 mg daily for 10 d,and then followed by 2 wk combination with nitrendipine or captorpil.Serum and urine digoxin concentration,cardiac function and other related clinical parameters were determined before and after l or 2 wk administration of nitrendipine or captopril.The results indicated that the digoxin serum concentration after 2 wk administration of captopril was dropped by 19%.The renal clearance of digoxin was increased by 35%,but the serum concentration and renal clearance of digoxin were not altered by nitrendipine.It was also found that administration of nitrendipine significantly improves cardiac function with no obvious difference as compared with captopril,suggesting that nitrendipine has a favorable effect like captopril in patients with severe congestive heart failure.