Schmidt B M, Smilde J, Oldenbroek C, Wehling M
Institut für Klinische Pharmakologie, Klinikum Mannheim, Universität Heidelberg.
Med Klin (Munich). 1998 Dec 15;93(12):701-6. doi: 10.1007/BF03044806.
This study was designed to evaluate the efficacy of intravenous quinaprilat in maintaining blood pressure control and to assess the safety of directly switching from oral angiotensin-converting enzyme (ACE) inhibitors to intravenous quinaprilate.
Following an initial 1-day open-label phase, patients with essential mild to moderate hypertension controlled by ACE inhibitor monotherapy were randomly assigned to treatment with intravenous quinaprilate (n = 36) or oral quinapril (n = 19) for a 3-day double-blind period. Quinaprilate (2.5, 5, or 10 mg BID) and quinapril (10, 20, or 40 mg OD) dosages were based on the patient's previous ACE inhibitor doses. The intravenously used dosages were half the dosages of orally administered enalapril, lisinopril and quinapril. Patients returned to their previous ACE inhibitor therapy during a second 1-day open-label phase.
Quinaprilate and quinapril maintained diastolic blood pressure control at levels comparable to those during the initial open-label ACE inhibitor treatment. The mean difference between quinaprilate and quinapril treatment groups in diastolic blood pressure showed no clinically relevant differences between treatment groups with regard to mean changes from baseline. Mean reductions in systolic blood pressure were similar to those of diastolic blood pressure.
Quinaprilate, at half the dose of quinapril, administered BID maintains blood pressure control, is well tolerated, and allows for safe conversion from previously applied oral ACE inhibitors. This finding is important for the antihypertensive treatment of patients in intensive care units or peri/post-operatively who cannot swallow orally administered drugs.
本研究旨在评估静脉注射喹那普利拉在维持血压控制方面的疗效，并评估直接从口服血管紧张素转换酶（ACE）抑制剂转换为静脉注射喹那普利拉的安全性。
在初始为期1天的开放标签阶段之后，接受ACE抑制剂单药治疗且血压得到控制的轻度至中度原发性高血压患者被随机分配至接受静脉注射喹那普利拉治疗（n = 36）或口服喹那普利治疗（n = 19），为期3天的双盲期。喹那普利拉（每日两次，剂量为2.5、5或10毫克）和喹那普利（每日一次，剂量为10、20或40毫克）的剂量基于患者先前使用的ACE抑制剂剂量。静脉使用的剂量为口服依那普利、赖诺普利和喹那普利剂量的一半。在第二个为期1天的开放标签阶段，患者恢复先前的ACE抑制剂治疗。
喹那普利拉和喹那普利在维持舒张压控制方面的水平与初始开放标签的ACE抑制剂治疗期间相当。喹那普利拉和喹那普利治疗组之间舒张压的平均差异在治疗组之间从基线的平均变化方面未显示出临床相关差异。收缩压的平均降低与舒张压相似。
喹那普利拉剂量为喹那普利的一半，每日两次给药可维持血压控制，耐受性良好，并允许从先前应用的口服ACE抑制剂安全转换。这一发现对于重症监护病房或围手术期/术后无法口服药物的患者的抗高血压治疗具有重要意义。
