Lanting P J, Brouwers T M, van Buuren H R, Stricker B H
Stichting Deventer Ziekenhuizen, afd. Interne Geneeskunde.
Ned Tijdschr Geneeskd. 1991 Feb 23;135(8):335-7.
Since 1984 25 cases of enalapril induced angioedema have been reported to the Netherlands Center for Monitoring of Adverse Reactions to Drugs. Two patients with enalapril induced angioedema are described. The pathophysiological mechanism of this potentially life-threatening adverse effect is probably not a direct allergic response to the drug itself. Enalapril inhibits angiotensin converting enzyme, which not only metabolizes angiotensin I but also bradykinin and 'substance P'. Bradykinin and 'substance PH may then accumulate and cause angioedema in a direct or indirect way. It is of great importance that instances of oropharyngeal swelling are considered a possible result of an adverse reaction to ACE-inhibitors.
自1984年以来，荷兰药物不良反应监测中心已收到25例依那普利诱发血管性水肿的报告。本文描述了2例依那普利诱发血管性水肿的患者。这种潜在的危及生命的不良反应的病理生理机制可能并非对药物本身的直接过敏反应。依那普利抑制血管紧张素转换酶，该酶不仅能代谢血管紧张素I，还能代谢缓激肽和P物质。缓激肽和P物质随后可能蓄积，并直接或间接导致血管性水肿。将口咽肿胀视为ACE抑制剂不良反应的可能结果非常重要。
