O'Hollaren M T, Porter G A
Division of Allergy and Clinical Immunology, Oregon Health Sciences University, Portland.
Ann Allergy. 1990 Jun;64(6):503-6.
Angiotensin converting enzyme inhibitors (ACEI) are used widely in the treatment of both hypertension and congestive heart failure. Although usually well tolerated, these medications may produce side effects that may be encountered by the allergist, including cough, angioedema, and rhinitis symptoms. The severity of ACEI-induced cough may vary, and is associated with increased bronchial hyperreactivity in some (but not all) patients as judged by methacholine sensitivity. Angiotensin converting enzyme inhibitor-induced cough may have its onset from one day to 12 months after initiation of therapy, and is not dose dependent. Angioedema caused by ACEI is usually mild and clears with discontinuation of the drug, however cases requiring intubation and tracheostomy have been reported. The mechanism of ACEI-induced cough remains unclear, but could be in part due to accumulation of substances whose degradation may also be impeded by ACEI, such as substance P, bradykinins, and/or prostaglandins. Knowledge of the side effects produced by this class of medication may help patients avoid unnecessary, costly, and often invasive diagnostic evaluations.
血管紧张素转换酶抑制剂（ACEI）广泛用于治疗高血压和充血性心力衰竭。尽管这些药物通常耐受性良好，但可能会产生一些过敏科医生可能会遇到的副作用，包括咳嗽、血管性水肿和鼻炎症状。ACEI引起的咳嗽严重程度可能不同，根据乙酰甲胆碱敏感性判断，在一些（但不是所有）患者中与支气管高反应性增加有关。血管紧张素转换酶抑制剂引起的咳嗽可能在治疗开始后一天至12个月内出现，且与剂量无关。ACEI引起的血管性水肿通常较轻，停药后可消退，然而，也有需要插管和气管切开术的病例报道。ACEI引起咳嗽的机制尚不清楚，但部分原因可能是某些物质的积累，而ACEI也可能会阻碍这些物质的降解，如P物质、缓激肽和/或前列腺素。了解这类药物产生的副作用可能有助于患者避免不必要的、昂贵的且往往具有侵入性的诊断评估。
