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我们观察了150例原发性高血压患者肌注速尿后的急性降压反应,并同18例对照组患者进行对比。结果显示:(1)肌注速尿后有快速而明显的利尿作用和降压效应。(2)利尿量的多少与患者的血AT Ⅱ或PRA无关;(3)降压作用的大小与利尿量多少或患者的血AT Ⅱ或PRA均无明显相关。结合文献复习,对速尿的降压机制进行讨论。我们的结果与Davidov和wilkison等的观察一致,但不支持Laragh等的结论。我们认为原发性高血压的升压机制及速尿的降压机制都是复杂的。速尿的降压并不是单纯由于利尿或容量削减,它的机制至今尚未完全阐明,需进一步研究。
We observed the acute hypotensive response after intramuscular furosemide in 150 patients with essential hypertension and compared them to 18 patients in the control group. The results showed that: (1) intramuscular furosemide has a rapid and obvious diuretic effect and antihypertensive effect. (2) The amount of diuresis has nothing to do with the patient’s blood AT Ⅱ or PRA; (3) The magnitude of the antihypertensive effect is not significantly related to the amount of diuresis or blood AT Ⅱ or PRA in patients. Combined with literature review, the mechanism of furosemide depressurization is discussed. Our results are consistent with the observations of Davidov and Wilkison, but do not support the conclusions of Laragh et al. We think the mechanism of the hypertension of essential hypertension and the hypotensive mechanism of furosemide are complex. Furosemide depressurization is not simply due to diuretic or capacity reduction, its mechanism has not been fully elucidated, need further study.