Reams G P, Bauer J H
J Clin Hypertens. 1986 Mar;2(1):55-63.
Enalapril, a potent long-acting angiotensin-converting enzyme inhibitor, was prescribed either alone (n = 9) or in combination (n = 20) with hydrochlorothiazide for 96 weeks in essential hypertensive subjects. Blood pressure was well controlled following both monotherapy or combination therapy. Plasma renin activity was stimulated in all subjects; plasma aldosterone concentration was stimulated only in subjects receiving combination therapy. Glomerular filtration rate (assessed by inulin clearance) was unchanged in subjects with initial clearances greater than 80 ml/min/1.73 m2 but was significantly improved (55%) following either form of therapy in subjects with initial clearances less than or equal to 80 ml/min/1.73 m2. Neither monotherapy nor combination therapy adversely affected 24-hour urinary protein excretion, sodium excretion, or body fluid composition. These results suggest that enalapril, either alone or in combination with hydrochlorothiazide, is effective therapy for mild to moderate hypertension. There are no adverse effect on renal function; indeed, enalapril has the capability of improving renal function in those subjects whose renal function was initially impaired from long-standing hypertension.
依那普利是一种强效长效血管紧张素转换酶抑制剂，在原发性高血压患者中，单独使用（n = 9）或与氢氯噻嗪联合使用（n = 20）96周。单药治疗或联合治疗后血压均得到良好控制。所有受试者的血浆肾素活性均受到刺激；仅接受联合治疗的受试者血浆醛固酮浓度受到刺激。初始清除率大于80 ml/min/1.73 m²的受试者，肾小球滤过率（通过菊粉清除率评估）无变化，但初始清除率小于或等于80 ml/min/1.73 m²的受试者，无论采用哪种治疗方式，肾小球滤过率均显著改善（55%）。单药治疗和联合治疗均未对24小时尿蛋白排泄、钠排泄或体液成分产生不利影响。这些结果表明，依那普利单独使用或与氢氯噻嗪联合使用，是治疗轻至中度高血压的有效疗法。对肾功能无不良影响；事实上，依那普利能够改善那些因长期高血压导致肾功能最初受损的受试者的肾功能。
