Dobroschke R, Georgi R, Krier C
Klinik für Anästhesiologie und operative Intensivmedizin des Katharinenhospitals, Stuttgart.
Anasthesiol Intensivmed Notfallmed Schmerzther. 1992 Dec;27(8):510-2. doi: 10.1055/s-2007-1000350.
Acute angioneurotic edema due to angiotensin converting enzyme (ACE) inhibitors usually develops shortly after therapy has been started. In this case, hypopharyngeal edema occurred with a delay of nine days. It required endotracheal intubation and could only be differentiated from an inflammatory process by examination under general anesthesia. The mechanism of action of ACE inhibitors, the pathogenesis of angioneurotic edema, its therapy outside as well as in the hospital, and the case described are being discussed. It is concluded that severe reactions induced by ACE inhibitors must be expected even after considerable time of therapy.
血管紧张素转换酶(ACE)抑制剂引起的急性血管神经性水肿通常在治疗开始后不久就会出现。在本病例中,下咽水肿延迟九天出现。需要进行气管插管,且只有在全身麻醉下检查才能与炎症过程相鉴别。本文讨论了ACE抑制剂的作用机制、血管神经性水肿的发病机制、其院外及院内治疗方法以及所描述的病例。得出的结论是,即使在治疗相当长一段时间后,也必须预期ACE抑制剂会引发严重反应。