HYDROCHLOROTHIAZIDE-AMILORIDE IN THE TREATMENT OF CONGENITAL NEPHROGENIC DIABETES-INSIPIDUS
HYDROCHLOROTHIAZIDE-AMILORIDE IN THE TREATMENT OF CONGENITAL NEPHROGENIC DIABETES-INSIPIDUS
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DOI：
10.1159/000166896
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发表时间：
1985-01-01
影响因子：
4.2
通讯作者：
CHAN, JCM
中科院分区：
文献类型：
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作者：
ALON, U;CHAN, JCM
比较了氢氯噻嗪联合阿米洛利与单用氢氯噻嗪治疗2例先天性肾源性尿崩症兄弟的疗效。尽管两种治疗方式均导致排尿频率和尿量减少、每日液体摄入量减少和尿渗透压升高，但2种药物联合治疗在预防尿钾丢失、低钾血症和尿潴留方面上级氢氯噻嗪单药治疗。阿米洛利在增加尿钠排泄量、减少尿量和游离水清除率、降低血清钠浓度和渗透压方面与噻嗪有一定的相加作用。氢氯噻嗪-阿米洛利方案与氢氯噻嗪-托美汀联合治疗的1例患者的相似比较显示，两种利尿方式的有效性接近，前者略占优势。2例患者治疗10 mo。与氢氯噻嗪和阿米洛利的联合给药没有显示出副作用，并且液体摄入量和尿量持续减少。氢氯噻嗪-阿米洛利方案上级优于氢氯噻嗪单药治疗，可作为氢氯噻嗪-前列腺素合成酶抑制剂联合治疗先天性肾源性尿崩症的令人满意的替代方案。
The effects of treatment with hydrochlorothiazide combined with amiloride were compared to hydrochlorothiazide treatment alone in 2 brothers with congenital nephrogenic diabetes insipidus. Whereas both modalities of treatment resulted in reduction in voiding frequency and urine volume, decrease in daily fluid intake and increase in urine osmolality, the 2-drug combination was superior to hydrochlorothiazide alone by preventing urinary K losses, hypokalemia and alkalosis. Amiloride had a certain additive effect to the thiazide in terms of increasing initial urinary Na excretion, reducing urine volume and free water clearance, and lowering serum Na concentration and osmolality. Similar comparison of the hydrochlorothiazide-amiloride regimen to treatment with the hydrochlorothiazide-tolmetin combination in 1 of the patients revealed that the effectiveness of both diuretic modalities was close with slight advantage of the former. Treatment of the 2 patients for 10 mo. with hydrochlorothiazide and amiloride showed no adverse effects and consistent reduction in fluid intake and urine volume. The hydrochlorothiazide-amiloride regimen is superior to hydrochlorothiazide alone and can be a satisfactory alternative to the hydrochlorothiazide-prostaglandin synthetase inhibitor combination in the treatment of congenital nephrogenic diabetes insipidus.