Onoyama K, Sanai T, Motomura K, Fujishima M
2nd Department of Internal Medicine, Faculty of Medicine, Kyushu University, Fukuoka City, Japan.
J Cardiovasc Pharmacol. 1989;13 Suppl 3:S27-30. doi: 10.1097/00005344-198900133-00007.
The effects of angiotensin converting enzyme (ACE) inhibitors and their combined use with an antiestrogenic steroid on erythropoiesis were investigated in patients on chronic hemodialysis (CHD). Hematocrit was decreased by 10% or more in 6 of 12 patients who received either captopril or enalapril for 2-6 months. Erythropoietin (Epo) and angiotensin II (AII) were significantly reduced in these patients. When treatment with mepitiostane was combined with ACE inhibitor, anemia was significantly improved but without evidence of changes in circulating Epo concentrations or indices of renin-angiotensin activity. The reduction of AII and Epo formation by ACE inhibitors seems to play an important role in the worsening of anemia in patients on CHD; addition of an antiestrogenic steroid should be considered.
在慢性血液透析（CHD）患者中，研究了血管紧张素转换酶（ACE）抑制剂及其与抗雌激素类固醇联合使用对红细胞生成的影响。在接受卡托普利或依那普利治疗2 - 6个月的12名患者中，有6名患者的血细胞比容降低了10%或更多。这些患者的促红细胞生成素（Epo）和血管紧张素II（AII）显著降低。当美替司坦治疗与ACE抑制剂联合使用时，贫血得到显著改善，但循环Epo浓度或肾素 - 血管紧张素活性指标无变化迹象。ACE抑制剂对AII和Epo生成的减少似乎在CHD患者贫血恶化中起重要作用；应考虑添加抗雌激素类固醇。
