Melby J C
Section of Endocrinology and Metabolism, Boston University School of Medicine, Massachusetts 02118.
Am J Cardiol. 1992 Apr 2;69(10):2C-7C. doi: 10.1016/0002-9149(92)90275-4.
Components of the renin-angiotensin system, and the ability to synthesize these components locally, have been demonstrated in cardiovascular tissues. Locally generated angiotensin II may affect vascular tone, regional blood flow, cardiac contractility, and vascular and cardiac growth. Local renin-angiotensin systems may exert autocrine and paracrine functions, whereas the circulating system serves an endocrine function. Use of angiotensin-converting enzyme (ACE) inhibitors has provided further clarification of the activities of local renin-angiotensin systems. Tissue and systemic effects of these agents may prove equally important in determining their clinical efficacy. Experiments with quinapril demonstrated that inhibition of vascular ACE was a significant component of the antihypertensive effect of the drug. Differences at the tissue level may have implications for the efficacy and tolerability of a particular agent. Improved individualization of therapy may be accomplished by the use of newer ACE inhibitors with very favorable side effects profiles and tissue specificity. The newest agent, quinapril, appears to exert an important effect on vascular converting enzyme.
肾素 - 血管紧张素系统的组成成分以及在局部合成这些成分的能力已在心血管组织中得到证实。局部产生的血管紧张素II可能会影响血管张力、局部血流、心脏收缩力以及血管和心脏的生长。局部肾素 - 血管紧张素系统可能发挥自分泌和旁分泌功能，而循环系统则发挥内分泌功能。使用血管紧张素转换酶（ACE）抑制剂进一步阐明了局部肾素 - 血管紧张素系统的活性。这些药物的组织和全身效应在确定其临床疗效方面可能同样重要。喹那普利的实验表明，抑制血管ACE是该药物降压作用的重要组成部分。组织水平的差异可能会影响特定药物的疗效和耐受性。通过使用具有非常良好副作用谱和组织特异性的新型ACE抑制剂，可以实现更个体化的治疗。最新的药物喹那普利似乎对血管转换酶有重要作用。
