Tifft C P, Gavras H, Kershaw G R, Gavras I, Brunner H R, Liang C S, Chobanian A V
Ann Intern Med. 1979 Jan;90(1):43-7. doi: 10.7326/0003-4819-90-1-43.
The diagnostic and therapeutic value of the angiotensin converting enzyme inhibitor teprotide (SQ 20881) was assessed in 18 patients with hypertensive emergencies. Mean blood pressure fell 31 +/- 18 mm Hg in the 10 subjects who responded to 1 mg/kg body weight administered intravenously, whereas it fell 5 +/- 3 mm Hg in the eight nonresponders. In patients who had received no previous drug treatment, log baseline plasma renin activity and change in mean blood pressure after SQ 20881 correlated significantly (r = 0.651, P less than 0.05). After acute therapy with SQ 20881, the patients who had a satisfactory response to the drug were treated with propranolol and a relatively normal sodium intake (88 meq/day). Nonresponders were treated with diuretics and sodium restriction (10 meq/day), and intermediate responders were given combination therapy. Mean blood pressure responded favorably within 24 h to the chosen regimen for each group from 152 +/- 47 to 102 +/- 31 mm Hg. SQ 20881 allows prompt evaluation of the role of renin in hypertensive emergencies and permits early choice of appropriate therapy based on the prevailing mechanism.
在18例高血压急症患者中评估了血管紧张素转换酶抑制剂替普罗肽（SQ 20881）的诊断和治疗价值。在静脉注射1mg/kg体重后有反应的10名受试者中，平均血压下降了31±18mmHg，而在8名无反应者中平均血压下降了5±3mmHg。在之前未接受过药物治疗的患者中，基线血浆肾素活性对数与SQ 20881治疗后的平均血压变化显著相关（r = 0.651，P<0.05）。在用SQ 20881进行急性治疗后，对该药物有满意反应的患者接受普萘洛尔治疗，并摄入相对正常的钠量（88meq/天）。无反应者接受利尿剂和钠限制（10meq/天）治疗，中等反应者给予联合治疗。每组患者的平均血压在24小时内对所选治疗方案反应良好，从152±47mmHg降至102±31mmHg。SQ 20881能够迅速评估肾素在高血压急症中的作用，并允许根据主要机制尽早选择合适的治疗方法。
