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作者最近曾遇到因服用阿斯匹林而引起对髓袢利尿药无反应导致严重少尿的心力衰竭病例。此患者是重度低排性心力衰竭和浮肿,相继给予洋地黄制剂、髓袢利尿药及安体舒通,由于患者有时患有两下肢血栓性静脉炎,而加用了阿斯匹林0.5g。结果导致尿量逐渐减少,全身浮肿加重和出现腹水。阿斯匹林(乙酰水杨酸)可以引起肾血流量减少,肾小球滤过率降低而抑制利尿,特别是肾脏疾病患者,可使血清肌酐酸、尿素氮升高。阿斯匹林还可影响利尿药的效果,尤其是阻断肾的醛固酮受体与安体舒通结合,可抑制安体舒通的抗醛固酮作用。但因其为一过性,故对无肾功衰竭者影响较少。
The authors have recently encountered cases of heart failure resulting in severe oliguria due to the lack of response to diopterus medulla due to taking aspirin. This patient is severe low-grade heart failure and edema, have been given digitalis preparations, diarrhea diosgenin and spironolactone, as patients sometimes suffer from thrombophlebitis of both lower extremities, and add aspirin 0.5g . As a result, urine volume gradually decreased, systemic edema increased, and ascites appeared. Aspirin (acetylsalicylic acid) can cause decreased renal blood flow, decreased glomerular filtration rate and inhibit diuretic, especially in patients with kidney disease, serum creatinine, urea nitrogen increased. Aspirin can also affect the diuretic effect, in particular, block the renal aldosterone receptor and spironolactone, spironolactone can inhibit the anti-aldosterone effect. However, because of its transient nature, it has less impact on those without renal failure.