De Groote P, Millaire A, Aisenfarb J C, Marquand A, Ducloux G
Service de Cardiologie, Hôpital Cardiologique, Lille.
Ann Cardiol Angeiol (Paris). 1988 May;37(5):251-3.
Regarding 5 recent cases of cough induced by inhibitors of angiotensin conversion enzyme (CEI), the authors emphasize the still underestimated frequency of this annoying and sometimes disabling side-effect (10 to 15% of cases). They remind of their clinical and evolutive characteristics: dry cough, predominantly at night, often occurring rapidly, sometimes delayed (up to 17 months) after introduction of the CEI and unrelated to the dosage. The cough usually disappears in two to three days (up to 8 days) upon discontinuation of the treatment. The test of discontinuation-reintroduction, possibly crossed (captopril/enalapril) is used in questionable cases as a diagnostic test. Besides, this diagnosis must be made rapidly in order to avoid costly, unnecessary laboratory tests which are sometimes unpleasant for the patient. The cough could be explained by an irritation of the bronchial mucosa secondary to bradykinin and pulmonary E2 prostaglandins elevation, under CEI.
关于最近5例由血管紧张素转换酶抑制剂（CEI）引起咳嗽的病例，作者强调这种恼人且有时会导致功能障碍的副作用的发生率仍被低估（10%至15%的病例）。他们回顾了其临床和演变特征：干咳，主要在夜间发作，通常迅速出现，有时在开始使用CEI后延迟出现（长达17个月），且与剂量无关。咳嗽通常在停药后两到三天（最长8天）消失。在可疑病例中，采用停药-再用药试验，可能采用交叉试验（卡托普利/依那普利）作为诊断试验。此外，必须迅速做出诊断，以避免进行昂贵、不必要的实验室检查，这些检查有时会让患者感到不适。咳嗽可能是由于在CEI作用下，缓激肽和肺E2前列腺素升高继发支气管黏膜刺激所致。
