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本文作者观察了用血管紧张素转换酶抑制剂甲琉丙脯酸(captopril)治疗硬皮病性肾脏危象的效果。本药试用于4例女性硬皮病伴发严重高肾素型高血压与肾动能急剧恶化的患者,血浆肾素活性(PRA)均明显增高,血清肌酐水平也有不同程度的增高,平均为3.5mg%,这些患者对降压利尿剂诸如硝普钠、肼苯哒嗪、速尿,可乐宁等药的疗效均不明显。第1例在出现晚期肾功能衰竭时血清肌酐升至7.5mg%,并以日增0.5mg的速率继续升高,需进行血液透析,改用甲巯丙脯酸25mg,每4小时口服1次后,血压下降,24小时尿量由500ml 增至1,500ml,由少尿性肾功能衰竭变为非少尿性肾功能衰竭,血清肌酐稳定在原水平而不再增高。其余3例用本药后亦获得类似
The authors observed the effect of treatment of scleroderma renal crisis with the captopril, an angiotensin converting enzyme inhibitor. The drug trial in 4 cases of female scleroderma with severe high renin hypertension and renal dysfunction in patients with deteriorating plasma renin activity (PRA) were significantly higher serum creatinine levels have varying degrees of increase, an average of 3.5 mg, these patients on antihypertensive agents such as sodium nitroprusside, hydralazine, furosemide, clonidine and other drugs are not obvious curative effect. In the first case, serum creatinine increased to 7.5 mg% in the presence of advanced renal failure and continued to increase at an increasing rate of 0.5 mg. Hemodialysis was required and 25 mg of captopril was switched to oral once every 4 hours After the blood pressure, 24-hour urine output increased from 500ml to 1,500ml, from oliguric renal failure into non-oliguric renal failure, serum creatinine stable at the original level and no longer increased. The remaining 3 cases were also similar after using this medicine