消心痛对充血性心力衰竭患者血浆地高辛浓度的影响

Influence of isosorbide dinitrate on the plasma digoxin concentration in patients with chronic congestive heart failure

对20例心衰患者动态观察了消心痛对地高辛血浆浓度的影响。结果表明:口服地高辛待血浆浓度稳定后加用消心痛,7～14夭后血浆地高辛浓度显著降低,肾地高辛清除率相应增加,但肾小球滤过率及肾血浆流量无明显变化。提示消心痛通过提高肾小管地高辛分泌清除率等影响地高辛稳定期血浆浓度。

In this study, the influence of isosorbide dinitrate on steady-state plasma concentration of the digoxin was observed in 20 hospitalized patients with CHF. None of the patients had a plasma BUN level greater than 20 mg/dl, or plasma creatinine greater than 2 mg/dl. The results show that 7-14 days after the administration of isosorbide dinitrate, the plasma digoxin concentration decreased by 20.7%. At the same time, the total renal digoxin clearance increased significantly, but no significant changes in glomerular filtration rate and renal plasma flow were noted. It indicates that isosorbide dinitrate could decrease steady-state digoxin plasma concentration through increasing the digoxin renal tubular secretion, etc. So when both drugs are used together careful adjustment of digoxin dosage should be taken.