Zech P Y, Trotta P, Labeeuw M
Nouv Presse Med. 1981 Apr 30;10(19):1571-4.
Of 58 patients treated with captopril, 3 have now received the drug for more than 2 years and 22 for more than one year. This study concerns 38 patients treated for 6 months, captopril having been given alone during the first 2 months. They all had severe hypertension (diastolic BP Greater Than 110 mmHg) which had resisted previous treatments in normally effective doses, including at least one beta-blocker, dihydralazine and a diuretic. After 6 months blood pressure levels were normal in 53% of the patients, reduced in 31% and unchanged in 16%. Clinical improvement was habitual with, in particular, disappearance or decrease of tiredness and dyspnoea. Since some side-effects of the drug, such as granulopenia, proteinuria and ageusia, are mainly observed with high dosage, captopril is usually administered in doses lower or equal to 400 mg/day. In resistant or malignant hypertension it must be used in combination with salt-free diet, a beta-blocker and/or prazosin. Clinical, haematological and renal surveillance is necessary during treatment. When these precautions are observed, captopril constitutes a very useful drug for the treatment of patients with severe resistant hypertension.
在接受卡托普利治疗的58名患者中，目前有3名患者用药已超过2年，22名患者用药超过1年。本研究涉及38名接受了6个月治疗的患者，在前2个月单独使用卡托普利。他们均患有严重高血压（舒张压大于110 mmHg），之前使用正常有效剂量的药物治疗均无效，这些药物至少包括一种β受体阻滞剂、双肼屈嗪和一种利尿剂。6个月后，53%的患者血压水平恢复正常，31%的患者血压降低，16%的患者血压未变。临床症状普遍改善，尤其是疲倦和呼吸困难消失或减轻。由于该药物的一些副作用，如粒细胞减少、蛋白尿和味觉丧失，主要在高剂量时出现，卡托普利通常以低于或等于400毫克/天的剂量给药。对于难治性或恶性高血压，必须与无盐饮食、β受体阻滞剂和/或哌唑嗪联合使用。治疗期间需要进行临床、血液学和肾脏监测。如果遵守这些预防措施，卡托普利对于治疗严重难治性高血压患者是一种非常有用的药物。
