California Poison Control System (CPCS) - Sacramento Division , Sacramento, CA , USA.
Clin Toxicol (Phila). 2013 Nov;51(9):864-70. doi: 10.3109/15563650.2013.834533. Epub 2013 Aug 22.
Lisinopril is an angiotensin converting enzyme inhibitor used for treatment of hypertension, congestive heart failure, and acute myocardial infarction. Reports of clinical experience with pediatric ingestions are minimal.
A 13-year retrospective study of lisinopril ingestions in children reported to the California Poison Control System was analyzed and case notes were reviewed. Institutional Review Board approval was obtained and cases were blinded. Inclusion criteria were lisinopril as a single ingestant, age less than 6 years, treatment in a health care facility, case followed to a known outcome.
Inclusion criteria were met in 296 cases. Demographics include 51% of male patients and the mean age was 1.97 years (range: 9 months-5 years). Of the 296 patients, 8 patients (2.7%) developed hypotension (ranges: 55-74 mm Hg systolic and 22-48 mm Hg diastolic). The lowest blood pressure of 55/22 mm Hg was recorded in a 22-month old male who ingested an estimated 120-mg lisinopril (13.3 mg/kg). The lowest dose of lisinopril causing hypotension was with an estimated dose of approximately 50 mg or 3.9 mg/kg in a 2-year old. Two hundred and eighty-two patients (95.3%) were treated and released from the emergency department and 14 patients (4.7%) were admitted. The dose ingested was reported in 189 cases and an exact-dose of lisinopril was reported in 61 patients (20.6%); mean amount ingested was 3.0 mg/kg, median amount ingested was 2.1 mg/kg (range: 0.1-10.9 mg/kg, N = 38); and mean total dose was 33.4 mg, median total dose was 20 mg (range: 2.5-160 mg, N = 61). None of the patients with exact-dose lisinopril ingestions developed hypotension, received intravenous fluids, or were admitted.
The lowest estimated dose of lisinopril to cause hypotension was 50 mg or 3.9 mg/kg. Although continued evaluation of pediatric lisinopril ingestions is essential to determine more specific thresholds of toxicity, the lack of effect on blood pressure in children with exact-dose ingestions indicate that pediatric lisinopril ingestions (for ages > 9 months) ≤ 4 mg/kg up to 40 mg total may be safely managed at home.
赖诺普利是一种血管紧张素转换酶抑制剂，用于治疗高血压、充血性心力衰竭和急性心肌梗死。有关儿科摄入的临床经验报告很少。
对向加利福尼亚毒物控制系统报告的儿童摄入赖诺普利的 13 年回顾性研究进行了分析，并查阅了病例记录。获得了机构审查委员会的批准，并对病例进行了盲法处理。纳入标准为赖诺普利单次摄入、年龄小于 6 岁、在医疗机构治疗、病例随访至明确结局。
296 例符合纳入标准。患者的人口统计学特征包括 51%为男性，平均年龄为 1.97 岁（范围：9 个月至 5 岁）。在 296 例患者中，有 8 例（2.7%）出现低血压（范围：收缩压 55-74mmHg，舒张压 22-48mmHg）。记录到的最低血压为 55/22mmHg，发生在一名 22 个月大的男性患儿，摄入估计剂量为 120mg 的赖诺普利（13.3mg/kg）。引起低血压的最低赖诺普利剂量为估计剂量约 50mg 或 3.9mg/kg，发生在一名 2 岁的患儿。282 例（95.3%）患者在急诊科接受治疗并出院，14 例（4.7%）患者住院。189 例报告了摄入剂量，61 例报告了确切剂量（20.6%）；平均摄入量为 3.0mg/kg，中位数摄入量为 2.1mg/kg（范围：0.1-10.9mg/kg，N=38）；平均总剂量为 33.4mg，中位数总剂量为 20mg（范围：2.5-160mg，N=61）。摄入确切剂量赖诺普利的患者均未出现低血压、接受静脉补液或住院。
引起低血压的最低估计赖诺普利剂量为 50mg 或 3.9mg/kg。尽管需要进一步评估儿科赖诺普利摄入以确定更具体的毒性阈值，但摄入确切剂量的儿童血压无变化表明，儿童摄入（年龄大于 9 个月）≤4mg/kg 时，摄入 40mg 以下的赖诺普利可能可以安全地在家中管理。
