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首页> 外文期刊>The Journal of Clinical Pharmacology: Official Journal of the American College of Clinical Pharmacology >Cough-challenge trial with a new angiotensin-converting enzyme inhibitor, imidapril.
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Cough-challenge trial with a new angiotensin-converting enzyme inhibitor, imidapril.

机译：新型血管紧张素转换酶抑制剂咪达普利的咳嗽试验。

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摘要

This study was conducted to examine whether imidaprilat, an active diacid of the angiotensin-converting enzyme (ACE) inhibitor imidapril, preferentially inhibits angiotensin I degradation rather than bradykinin degradation, and whether imidapril is less active than other ACE inhibitors in inducing cough in patients with hypertension. The effect of imidaprilat on the inhibition of pressor response to angiotensin I and augmentation of depressor response to bradykinin was compared with that of enalaprilat and captopril in anesthetized rats. To determine the incidence of cough associated with imidapril, patients with a history of ACE inhibitor-induced dry cough were enrolled in a randomized, open-labeled, crossover trial with two 6-week periods to be treated with imidapril or amlodipine, a calcium-channel blocker. The recurrence of cough was assessed during both treatments. In the animal study, there were no significant differences in the ratio of inhibition of pressor response to angiotensin I and the augmentation of depressor response to bradykinin among the ACE inhibitors. In the cough-challenge trial, a total of 60 patients with hypertension were enrolled in the study. Cough and cough related symptoms recurred in 98.3% of the patients (59/ 60) during imidapril therapy. In contrast, only two patients reported cough during treatment with amlodipine. These results indicate that imidapril has no selectivity in inhibiting angiotensin I- and bradykinin-degradation in rats, and that clinically it is not different from other ACE inhibitors in inducing cough in patients with hypertension.
机译：这项研究的目的是检查血管紧张素转换酶（ACE）抑制剂咪达普利的活性二酸咪达普利拉是否优先抑制血管紧张素I的降解而不是缓激肽的降解，以及咪达普利在诱导咳嗽患者中是否比其他ACE抑制剂活性低。高血压。在麻醉大鼠中，比较了依那普利拉对血管紧张素I的升压反应的抑制作用和对缓激肽的降压反应的增强作用与依那普利拉和卡托普利的作用。为了确定与吡虫啉相关的咳嗽的发生率，将有ACE抑制剂引起的干咳病史的患者纳入一项随机，开放标签，交叉试验，为期两个为期6周的治疗，接受吡虫啉或氨氯地平，钙通道阻止程序。在两种治疗中均评估了咳嗽的复发。在动物研究中，ACEI抑制剂对血管紧张素I的升压反应抑制率和缓激肽的降压反应增强率没有显着差异。在咳嗽挑战试验中，共有60名高血压患者参加了该研究。在吡虫啉治疗期间，98.3％的患者（59/60）复发了与咳嗽相关的症状。相比之下，氨氯地平治疗期间仅两名患者报告咳嗽。这些结果表明，咪达普利在抑制大鼠血管紧张素I和缓激肽降解方面没有选择性，并且在临床上与其他ACE抑制剂在诱发高血压患者咳嗽方面没有区别。

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