Bas M, Kojda G, Stelter K
Hals-Nasen-Ohrenklinik und Poliklinik, Klinikum rechts der Isar, Technische Universität München, Deutschland.
Anaesthesist. 2011 Dec;60(12):1141-5. doi: 10.1007/s00101-010-1798-3. Epub 2010 Oct 6.
Angiotensin-converting enzyme (ACE) inhibitors block the catalysis of angiotensin I to angiotensin II and also the breakdown of bradykinin. ACE inhibitor-induced angioedema is mediated by inhibited bradykinin degradation leading to enhanced bradykinin plasma levels. The efficacy of currently used standard treatments with antiallergic drugs is questionable. A patient with acute ACE inhibitor-induced angioedema was treated with icatibant, a specific bradykinin B2 receptor antagonist approved for the treatment of hereditary angioedema. A single subcutaneous injection of 30 mg icatibant resulted in a rapid onset of symptom relief and a remarkable shortening of duration of the attack.
血管紧张素转换酶（ACE）抑制剂可阻断血管紧张素I向血管紧张素II的催化过程，同时也能抑制缓激肽的降解。ACE抑制剂诱发的血管性水肿是由缓激肽降解受抑制介导的，导致血浆中缓激肽水平升高。目前使用抗过敏药物的标准治疗方法的疗效存在疑问。一名急性ACE抑制剂诱发血管性水肿的患者接受了依卡替班治疗，依卡替班是一种被批准用于治疗遗传性血管性水肿的特异性缓激肽B2受体拮抗剂。单次皮下注射30毫克依卡替班可迅速缓解症状，并显著缩短发作持续时间。
