van den Broek S A, de Graeff P A, Smit A J, Girbes A R, van Gilst W H, Hillege H, van Veldhuisen D J, Wesseling H, Lie K I
Department of Cardiology/Thoraxcenter, University Groningen, The Netherlands.
J Cardiovasc Pharmacol. 1995 Jan;25(1):105-12. doi: 10.1097/00005344-199501000-00017.
Spirapril is a new angiotensin-converting enzyme (ACE) inhibitor with a long duration of action. To determine whether duration of inhibition of serum ACE activity may affect regional blood flow (RBF), we compared spirapril with captopril, an ACE inhibitor with a short duration of action. Both the short- and long-term effects were studied in patients with mild to moderate congestive heart failure (CHF). Calf, renal, and hepatic BF measurements were performed in the morning before intake of the study medication; 24 h after the previous dose of spirapril (n = 9 patients) and 12 h after the previous dose of captopril (n = 9 patients). Serum ACE activity after 1, 6, and 12 weeks was significantly reduced in patients receiving spirapril, but not in those receiving captopril. The decrease in mean arterial pressure (MAP) was more pronounced in the spirapril group. Calf BF showed a slight but not significant increase in both spirapril- and captopril-treated patients. Effective renal BF increased significantly only in patients treated with spirapril. Although filtration fraction (FF) tended to decrease in the spirapril group, the decrease was significant only in the captopril group. No changes were observed in hepatic BF. Cerebral BF (CBF) measurements were performed after intake of the first dose of study medication and after 12 weeks, immediately after drug intake. Significant reduction in MAP in the two treatment groups both after the first dose and after 12 weeks did not affect CBF. Despite a significantly prolonged decrease in MAP and serum ACE activity in spirapril-treated patients, no marked differences in RBF were noted between the two ACE inhibitors.
螺普利是一种作用持续时间长的新型血管紧张素转换酶（ACE）抑制剂。为了确定血清ACE活性抑制的持续时间是否会影响局部血流量（RBF），我们将螺普利与卡托普利（一种作用持续时间短的ACE抑制剂）进行了比较。在轻度至中度充血性心力衰竭（CHF）患者中研究了短期和长期效应。在服用研究药物前的早晨进行小腿、肾脏和肝脏血流量测量；在服用螺普利前一剂后24小时（n = 9例患者）和服用卡托普利前一剂后12小时（n = 9例患者）进行测量。接受螺普利治疗的患者在1、6和12周后血清ACE活性显著降低，但接受卡托普利治疗的患者未出现这种情况。螺普利组平均动脉压（MAP）的下降更为明显。在接受螺普利和卡托普利治疗的患者中，小腿血流量均有轻微但不显著的增加。仅在接受螺普利治疗的患者中，有效肾血流量显著增加。虽然螺普利组滤过分数（FF）有下降趋势，但仅在卡托普利组下降显著。肝脏血流量未观察到变化。在服用第一剂研究药物后以及12周后服药后立即进行脑血流量（CBF）测量。两个治疗组在第一剂后和12周后MAP的显著降低均未影响CBF。尽管螺普利治疗的患者MAP和血清ACE活性显著延长降低，但两种ACE抑制剂之间在RBF方面未发现明显差异。
