Waeber B, Schaller M D, Wauters J P, Brunner H R
Klin Wochenschr. 1984 Aug 1;62(15):728-30. doi: 10.1007/BF01725706.
The orally active angiotensin-converting enzyme inhibitor captopril was administered for up to 11 weeks to three patients with progressive systemic sclerosis presenting with hypertension and plasma creatinine levels of 3.1, 7.2 and 10.4 mg/100 ml. Only one patient had malignant phase hypertension. In this patient a diuretic had to be added to captopril in order to keep blood pressure under control. Despite sustained blood pressure control during captopril administration, renal function deteriorated and hemodialysis treatment had to be started in all patients. Up to that time no substantial improvement in skin lesions was observed. During the period of dialysis, blood pressure was normal in all patients even though administration of captopril was discontinued. All three patients died of respiratory failure while on chronic hemodialysis for 3 to 4 weeks. These observations confirm that angiotensin-converting enzyme inhibition may be helpful in controlling blood pressure of patients with scleroderma. However, in contrast to some earlier reports, they also indicate that converting enzyme inhibition does not always prevent the multivisceral vascular lesions of scleroderma.
对3例进行性系统性硬化症患者给予口服活性血管紧张素转换酶抑制剂卡托普利，治疗长达11周。这3例患者均有高血压，血浆肌酐水平分别为3.1、7.2和10.4mg/100ml。仅1例患者有恶性高血压。为控制血压，该患者在服用卡托普利时必须加用利尿剂。尽管在服用卡托普利期间血压持续得到控制，但所有患者的肾功能均恶化，不得不开始血液透析治疗。在此之前，未观察到皮肤病变有实质性改善。在透析期间，尽管停用了卡托普利，但所有患者的血压均正常。3例患者在进行3至4周的慢性血液透析时均死于呼吸衰竭。这些观察结果证实，血管紧张素转换酶抑制可能有助于控制硬皮病患者的血压。然而，与一些早期报告不同的是，它们还表明，转换酶抑制并不总能预防硬皮病的多脏器血管病变。
