Tielemans C, Madhoun P, Lenaers M, Schandene L, Goldman M, Vanherweghem J L
Department of Nephrology, Dialysis, and Transplantation, Hôpital Erasme, Université Libre de Bruxelles, Belgium.
Kidney Int. 1990 Nov;38(5):982-4. doi: 10.1038/ki.1990.301.
We report five life-threatening anaphylactoid reactions occurring within the very first minutes of hemodialysis on polyacrylonitrile (AN69) capillary dialyzers in three patients receiving ACE inhibitors. Such reactions were not observed either in patients treated with ACE inhibitors but dialyzed on other membranes (N = 9), nor in patients on AN69 who did not receive ACE inhibitors (N = 19). These anaphylactoid reactions could be due to bradykinin accumulation, as a result of both increased synthesis--by interaction of blood with the AN69 polymer--and catabolism blockade by ACE inhibitors.
我们报告了3例接受血管紧张素转换酶抑制剂（ACE抑制剂）治疗的患者，在使用聚丙烯腈（AN69）毛细管透析器进行血液透析的最初几分钟内发生了5次危及生命的类过敏反应。在接受ACE抑制剂治疗但使用其他透析膜进行透析的患者中（n = 9），以及在未接受ACE抑制剂治疗的使用AN69透析器的患者中（n = 19），均未观察到此类反应。这些类过敏反应可能是由于缓激肽蓄积所致，这是血液与AN69聚合物相互作用导致合成增加以及ACE抑制剂抑制分解代谢共同作用的结果。
