Waeber B, Burnier M, Nussberger J, Brunner H R
Division d'hypertension, Centre hospitalier universitaire vaudois, Lausanne.
Schweiz Med Wochenschr. 1987 Sep 12;117(37):1359-62.
Angiotensin converting enzyme (ACE) inhibitors are widely used today for the management of hypertension and congestive heart failure. These agents inhibit angiotensin II synthesis. In some particular circumstances they may be responsible for deterioration of renal function, e.g. in hypertensive patients with bilateral renal artery stenosis or with stenosis of the artery supplying a single kidney, or in patients with severe congestive heart failure or marked nephroangiosclerosis. In these patients renal perfusion pressure may become too low to maintain adequate glomerular filtration as there remains no angiotensin II to increase the tone of the efferent arteriole. In high risk patients it is therefore recommended that serum creatinine be checked after initiating therapy with an ACE inhibitor.
血管紧张素转换酶（ACE）抑制剂如今被广泛用于治疗高血压和充血性心力衰竭。这些药物可抑制血管紧张素II的合成。在某些特定情况下，它们可能导致肾功能恶化，例如在双侧肾动脉狭窄或单肾供血动脉狭窄的高血压患者中，或在严重充血性心力衰竭或明显肾血管硬化的患者中。在这些患者中，由于没有血管紧张素II来增加出球小动脉的张力，肾灌注压可能会变得过低，以至于无法维持足够的肾小球滤过。因此，对于高危患者，建议在开始使用ACE抑制剂治疗后检查血清肌酐。
