Kawakami N, Yamashita T, Nakano S, Ishihara H, Kitahara T, Nakashima K, Kashiwagi S, Ito H
Department of Neurosurgery, Yamaguchi University School of Medicine, Japan.
Acta Neurol Scand Suppl. 1996;166:93-5. doi: 10.1111/j.1600-0404.1996.tb00560.x.
Most of patients with cerebrovascular disease are associated with hypertension. Hypertension induces progressive atheromatous changes in cerebral arteries, and often causes steno-occlusive lesions of cerebral arteries. Angiotensin converting enzyme (ACE) inhibitor cilazapril is one of the antihypertensive drugs. It was reported that cilazapril improved resting cerebral blood flow (CBF) and cerebrovascular reserve capacity (CRC) in experimental studies. In this clinical study, the authors investigated whether long-term treatment with cilazapril could improve CBF and CRC in patients with steno-occlusive lesions of the major cerebral arterial trunk, measured by stable xenon computerized tomography (Xe-CT) with acetazolamide challenge. On the other hand, CBF and CRC in the calcium blocker-treated patients were measured in the same way. CBF did not change after long-term treatment with both cilazapril and calcium blocker. In the cilazapril-treated group, CRC was increased significantly (p < 0.05). However, CRC did not change in the calcium blocker-treated group. It was recognized that long-term treatment with cilazapril did not decrease CBF and improved CRC in patients with occlusive lesions of the major cerebral arterial trunk.
大多数脑血管疾病患者都与高血压有关。高血压会导致脑动脉出现进行性动脉粥样硬化改变，并常引起脑动脉的狭窄闭塞性病变。血管紧张素转换酶（ACE）抑制剂西拉普利是一种降压药物。据报道，在实验研究中，西拉普利可改善静息脑血流量（CBF）和脑血管储备能力（CRC）。在这项临床研究中，作者通过乙酰唑胺激发试验，采用稳定氙计算机断层扫描（Xe-CT）测量，研究长期使用西拉普利治疗是否能改善大脑主要动脉干狭窄闭塞性病变患者的CBF和CRC。另一方面，以同样的方式测量钙通道阻滞剂治疗患者的CBF和CRC。长期使用西拉普利和钙通道阻滞剂治疗后，CBF均未发生变化。在西拉普利治疗组中，CRC显著增加（p<0.05）。然而，钙通道阻滞剂治疗组的CRC没有变化。研究发现，长期使用西拉普利不会降低大脑主要动脉干闭塞性病变患者的CBF，反而会改善其CRC。
