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动脉高血压合并肝脏病变的联合治疗。血管紧张素转换酶抑制剂的地位

[Combination therapy of arterial hypertension combined with liver pathology. The place of angiotensin converting enzyme inhibitors].

作者信息

Lazebnik L B, Komissarenko I A, Mikheeva O M, Drozdov V N, Sil'vestrova S Iu, Petrakov A V

出版信息

Kardiologiia. 2009;49(3):28-33.

Abstract

It is necessary to take into account presence of concomitant pathology while prescribing hypotensive therapy to patients with arterial hypertension (AH). Hydrophilic angiotensin converting enzyme inhibitors (ACEI) (lisinopril) which are not metabolized in the liver are theoretically safest in liver cirrhosis. We have examined and treated 180 patients with AH and assessed efficacy and tolerability of ACEI lisinopril and enalapril with consideration of their pharmacokinetic peculiarities in patients with various severity of involvement of the liver (steatosis or cirrhosis). Advantage of hypotensive effect of lisinopril (which required no biotransformation in the liver) over enalapril based on its pharmacokinetic properties has been demonstrated.

摘要

在给动脉高血压(AH)患者开降压药时,有必要考虑伴随疾病的存在。在肝硬化患者中,理论上在肝脏中不代谢的亲水性血管紧张素转换酶抑制剂(ACEI)(赖诺普利)是最安全的。我们检查并治疗了180例AH患者,并根据不同肝脏受累严重程度(脂肪变性或肝硬化)患者的药代动力学特点,评估了ACEI赖诺普利和依那普利的疗效和耐受性。基于其药代动力学特性,已证明赖诺普利(在肝脏中无需生物转化)的降压效果优于依那普利。

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