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[咳嗽、支气管收缩和支气管高反应性与血管紧张素转换酶治疗的关系]

[Cough, bronchoconstriction and bronchial hyperreactivity in relation to treatment with angiotensin-converting enzyme].

作者信息

Szmidt M, Minc P

机构信息

II Kliniki Gruzlicy i Chorób Płuc Instytutu Gruzlicy i Chorób Płuc w Lodzi.

出版信息

Pol Merkur Lekarski. 1999 May;6(35):281-5.

Abstract

In the paper available information concerning the influence of treatment with angiotensin converting enzyme inhibitors (ACE-I) on cough, bronchial hyperreactivity and bronchoconstriction are reviewed. Cough occurs in 0.7% to 19% of patients treated with angiotensin converting enzyme inhibitors according to various reports. In the mechanism of angiotensin converting enzyme inhibitor-induced cough accumulation of bradykinin and substance P due to decreased degradation of this mediators caused by ACE-I may be involved. Part of tussive effect may be mediated via prostaglandins and histamine. In a few studies symptoms of airway obstruction and asthma worsening in relation to treatment with this drugs was reported. However, majority of reports suggest safety in taking ACE-I by patients with asthma. The only effective method to relieve angiotensin converting enzyme-induced cough is a drug withdrawal. The change of drugs within the whole class of ACE-I does not bring effect.

摘要

本文综述了有关血管紧张素转换酶抑制剂(ACE-I)治疗对咳嗽、支气管高反应性和支气管收缩影响的现有信息。根据各种报告,接受血管紧张素转换酶抑制剂治疗的患者中,咳嗽发生率为0.7%至19%。在血管紧张素转换酶抑制剂引起咳嗽的机制中,可能涉及由于ACE-I导致这些介质降解减少而使缓激肽和P物质蓄积。部分咳嗽效应可能通过前列腺素和组胺介导。在一些研究中,报告了与使用此类药物治疗相关的气道阻塞和哮喘恶化症状。然而,大多数报告表明哮喘患者服用ACE-I是安全的。缓解血管紧张素转换酶引起咳嗽的唯一有效方法是停药。在整个ACE-I类药物中更换药物无效。

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