血管紧张素转换酶抑制剂所致慢性咳嗽患者的乙酰甲胆碱吸入激发试验

Methacholine inhalation challenge in patients with chronic cough induced by angiotensin-converting enzyme inhibitors.

作者信息

Wongtim S, Chareonlap P, Mogmued S

机构信息

Department of Internal Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

J Med Assoc Thai. 1996 Mar;79(3):166-70.

PMID:8708498

Abstract

Angiotensin-converting enzyme inhibitors (ACEI) cause cough in some patients, but the mechanism of this side effect is not clear. Five patients (group I) who had developed chronic cough induced by ACEI were evaluated to determine the bronchial hyperreactivity (BHR) by challenge with methacholine inhalation using a reservoir method at Respiratory Unit, Chulalongkorn Hospital University. Five patients (group II) who did not experience coughing associated with ACEI were also challenged as controls. The results revealed that two patients (40%) in group I demonstrated BHR with the mean PC20 at 15 mg/ml of methacholine solution. On the other hand, none of the patients in group II disclosed BHR. We concluded that coughing during ACEI therapy may be due to an increased inflammatory state in the airway in some susceptible subjects.

摘要

血管紧张素转换酶抑制剂（ACEI）会使一些患者出现咳嗽，但这种副作用的机制尚不清楚。在朱拉隆功大学医院呼吸科，对5例因ACEI诱发慢性咳嗽的患者（第一组）进行评估，采用贮液器法通过吸入乙酰甲胆碱激发试验来测定支气管高反应性（BHR）。另外选取5例未出现与ACEI相关咳嗽的患者（第二组）作为对照进行激发试验。结果显示，第一组中有2例患者（40%）表现出BHR，乙酰甲胆碱溶液的平均PC20为15mg/ml。另一方面，第二组患者均未出现BHR。我们得出结论，在一些易感人群中，ACEI治疗期间的咳嗽可能是由于气道炎症状态增加所致。