Burnier M, Waeber B, Nussberger J, Brunner H R
Division of Hypertension, University Hospital, Lausanne, Switzerland.
J Hypertens Suppl. 1989 Sep;7(7):S27-31. doi: 10.1097/00004872-198909007-00006.
The unique ability of angiotensin converting enzyme (ACE) inhibitors to inhibit the generation of angiotensin II has made them very useful agents for treating patients with renovascular hypertension. Their efficacy in lowering blood pressure in this type of secondary hypertension is now well established. However, episodes of acute renal failure may occur during ACE inhibition, particularly when renal perfusion is compromised. This is often the case in patients with renal artery stenosis and a single kidney or with bilateral renal artery stenosis. In recent years, investigators have shown concern at the long-term fate of the stenotic kidney in patients with unilateral renal artery stenosis who are treated with ACE inhibitors. Although overall renal function remained stable, a decrease in glomerular filtration was demonstrated in the stenotic kidney under ACE inhibition. The long-term implications of this observation merit further investigations.
血管紧张素转换酶（ACE）抑制剂抑制血管紧张素II生成的独特能力，使其成为治疗肾血管性高血压患者的非常有用的药物。它们在降低这类继发性高血压患者血压方面的疗效现已得到充分证实。然而，在使用ACE抑制剂期间可能会发生急性肾衰竭，尤其是在肾灌注受损时。肾动脉狭窄且为单肾的患者或双侧肾动脉狭窄的患者常常如此。近年来，研究人员对单侧肾动脉狭窄患者使用ACE抑制剂治疗后狭窄肾脏的长期转归表示关注。尽管总体肾功能保持稳定，但在ACE抑制作用下，狭窄肾脏的肾小球滤过率有所下降。这一观察结果的长期影响值得进一步研究。
