血管紧张素转换酶抑制剂与咳嗽关系的临床研究

目的　探讨血管紧张素转换酶抑制剂 (ACEI)与咳嗽的关系。　方法　以单独和联合服用 ACEI(培哚普利或苯那普利 )降压治疗的 85 1例高血压患者为研究组 ;以 30 5例年龄、性别、病情相仿 ,服用长效二氢吡啶类钙拮抗剂 (硝苯吡啶控释片或氨氯地平 )的高血压患者为对照组。对两组咳嗽的发生率进行比较。　结果　 ACEI组咳嗽发生率为 14 .8% (12 6 / 85 1) ,对照组为 0 .7% (2 / 30 5 ,P<0 .0 0 1)。经多因素 L ogistic逐步回归分析表明 ,影响咳嗽的主要因素是肾功能、ACEI和剂量 ,OR值分别为 3.5 8(OR95 % CI2 .34～ 5 .4 7,P<0 .0 0 1)、18.5 1(OR95 % CI4 .4 4～ 77.11,P<0 .0 0 1)和 1.5 2 (OR 95 % CI 1.12～ 2 .0 8,P<0 .0 1)。进一步分析发现 ,ACEI组肾功能正常和异常组咳嗽发生率分别为 11.3% (81/ 714 )和 32 .8% (45 / 137,P<0 .0 0 1)。　结论　 ACEI所致的咳嗽副作用与剂量和肾功能有关 ,而与年龄和性别无关

Angiotensin-converting Enzyme Inhibitors and Cough

Objective To study the relationship between use of angiotensin|converting enzyme inhibitors(ACEI) and cough in hypertensive treatment. Methods A case|control study was carried out in 851 patients in the department of internal medicine, Fujian provincial cardiovascular disease institute during January 1995 to December 1999 who were taking ACEI which included perindopril or benazepril for hypertension, compared with 305 patients matched for sex and age receiving long|acting calcium channel blockers(nifedipine GITS or amlodipine). Results The prevalence of cough were 14 8%(126/851) of patients taking ACEI and 0 7%(2/305) of the controls(P<0 001). Multiple logistic stepwise regression analysis showed that the main influenced factors of cough were ACEI, renal function and drug dosage(OR=18 51, 95%CI 4 44~77 11, P<0 001; OR=3 58, 95%CI 2 34~5 47 P<0 001 and OR=1 52, 95%CI 1 12~2 08, P<0 01, respectively). Further study showed that the prevalence rate of cough in ACEI group were 11.3%(81/714) and 32.8%(45/137, P<0.001) in normal and abnormal renal function groups, respectively. Conclusion The cough induced by ACEI is related significantly to renal function and drug dosage, but without related to age and sex.;