Winters Michael E, Rosenbaum Steven, Vilke Gary M, Almazroua Faisal Y
University of Maryland School of Medicine, Baltimore, Maryland.
J Emerg Med. 2013 Nov;45(5):775-80. doi: 10.1016/j.jemermed.2013.05.052. Epub 2013 Aug 26.
Angiotensin-converting-enzyme inhibitors (ACEI) are one of the most prescribed medications worldwide. Angioedema is a well-recognized adverse effect of this class of medications, with a reported incidence of ACEI angioedema of up to 1.0%. Of importance to note, ACEI angioedema is a class effect and is not dose dependent. The primary goal of this literature search was to determine the appropriate Emergency Department management of patients with ACEI angioedema.
A MEDLINE literature search from January 1990 to August 2012 and limited to human studies written in English for articles with keywords of ACEI angioedema. Guideline statements and non-systematic reviews were excluded. Studies identified then underwent a structured review from which results could be evaluated.
Five hundred sixty-two papers on ACEI angioedema were screened and 27 appropriate articles were rigorously reviewed in detail and recommendations given.
The literature search did not support any specific treatment protocol with a high level of evidence due to the limited--and limitations of the--available studies.
血管紧张素转换酶抑制剂（ACEI）是全球处方量最多的药物之一。血管性水肿是这类药物一种广为人知的不良反应，据报道，ACEI 所致血管性水肿的发生率高达 1.0%。需要注意的是，ACEI 所致血管性水肿是类效应，且与剂量无关。本次文献检索的主要目的是确定急诊科对 ACEI 所致血管性水肿患者的恰当处理方法。
对 1990 年 1 月至 2012 年 8 月期间的 MEDLINE 文献进行检索，仅限于用英文撰写的关于 ACEI 所致血管性水肿的人体研究文章。排除指南声明和非系统性综述。对检索到的研究进行结构化综述，以便评估结果。
筛查了 562 篇关于 ACEI 所致血管性水肿的论文，对 27 篇合适的文章进行了严格详细的综述并给出了建议。
由于现有研究数量有限及其局限性，文献检索未支持任何具有高度证据水平的特定治疗方案。
