Seelig C B, Maloley P A, Campbell J R
Department of Internal Medicine, College of Pharmacy, University of Nebraska, Omaha.
South Med J. 1990 Oct;83(10):1144-8. doi: 10.1097/00007611-199010000-00007.
Angiotensin-I converting enzyme (ACE) inhibitors and nonsteroidal anti-inflammatory drugs (NSAIDs) can be nephrotoxic and may synergistically compromise renal function. A computer-assisted study was done to asses the prevalence of compromised renal function and the clinical importance of this drug interaction. A search of the records of all patients seen in the University of Nebraska Medical Center Internal Medicine Clinic was conducted to identify cases involving renal insufficiency, therapy with ACE inhibitors, or therapy with NSAIDs. Records of cases meeting these criteria were reviewed for clinical correlation and revealed 2278 patients treated with NSAIDs, 328 with ACE inhibitors, and 162 with both. No nephrotoxicity was found in conjunction with monotherapy, but three cases of reversible renal failure were found in conjunction with combination therapy. Significant nephrotoxicity during the concomitant use of ACE inhibitors and NSAIDs is not uncommon, and attention should be drawn to this potentially important interaction.
血管紧张素转换酶（ACE）抑制剂和非甾体抗炎药（NSAIDs）可能具有肾毒性，并且可能协同损害肾功能。进行了一项计算机辅助研究，以评估肾功能受损的患病率以及这种药物相互作用的临床重要性。检索了内布拉斯加大学医学中心内科诊所诊治的所有患者的记录，以确定涉及肾功能不全、接受ACE抑制剂治疗或接受NSAIDs治疗的病例。对符合这些标准的病例记录进行了临床相关性审查，结果显示，2278例患者接受了NSAIDs治疗，328例接受了ACE抑制剂治疗，162例同时接受了这两种药物治疗。单药治疗未发现肾毒性，但联合治疗发现了3例可逆性肾衰竭病例。ACE抑制剂和NSAIDs联合使用期间出现显著肾毒性的情况并不少见，应关注这种潜在的重要相互作用。
