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自从1977年血管紧张素转换酶抑制剂(Angiotension converting enzyme inhibitor.ACEI)卡托普利(巯甲丙脯酸,captopril)问世以来、众多的研究表明.卡托普利、依那普利(enalpril)治疗高血压和充血性心力衰竭(CHF)均取得了令人满意的疗效.并具有心肌保护、逆转左室肥厚、改善糖代谢、提高生活质量及降低CHF的病死率等良好作用.系前景良好且发展较快的一类药物.新型ACEI不断问世.除常用的依那普利外、已有应用报道的还有20余种之多.与卡托普利比较,它们大多半衰期长、作用持久、服用方便(每日1次),国内亦始有临床应用的报道、现就其报道较多且具有一定代表性的7种综述如下.1 药代动力学卡托普利为具有活性的ACEI,口服吸收后可直接发挥血管紧张素转换酶(ACE)抑制作用.以依那普利为代表的大多新型ACEI则不同,它们是前体药,吸收后通过酯解转化为有活性的双酸代谢物而发挥ACE抑制作用、如依那普利转化为依那普利拉(enalaprilat),培哚普利(perindopril)转化为培普
Since the advent of captopril of the angiotensin converting enzyme inhibitor (ACE) in 1977, numerous studies have shown that captopril, enalpril (enalpril) ) Has achieved satisfactory results in the treatment of hypertension and congestive heart failure (CHF) and has a good effect of myocardial protection, reversing left ventricular hypertrophy, improving glucose metabolism, improving quality of life and reducing the mortality of CHF. Good and rapid development of a class of drugs. New ACEI continue to come out. In addition to commonly used enalapril, there have been more than 20 kinds of applications reported compared with captopril, most of them have a long life, the role Long-lasting, easy to take (once daily), the domestic clinical application of the first reported, now its more reported and representative of the 7 are summarized as follows.1 Pharmacokinetics Captopril as an active ACEI can directly exert the inhibitory effect of angiotensin converting enzyme (ACE) after oral absorption.Most of new ACEIs represented by enalapril are different, they are prodrugs, which are converted into active bis Acid metabolites and hair ACE inhibition, such as conversion of enalapril enalaprilat (enalaprilat), perindopril (perindopril) into Peipu