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巯甲丙脯氨酸对耐药性高血压和肾动脉狭窄均可能有效,而有耐药性的高血压病人常有广泛血管疾病和某种程度的肾功损害。作者连续对22例难治的高血压病人用巯甲丙脯氨酸治疗,发现有3例在用小剂量时(25—150毫克/天),肾功迅速恶化。3例用巯甲丙脯氨酸前均有严重血管疾病(2例因间歇性跛行曾行手术,1例为主动脉瘤扩展超过肾血管部),但均无失水、血压下降、蛋白尿和尿潴留,停药后一月内,血压用其它降压药控制有进步,肾功完全恢复,主动脉造影显示单个有功能肾伴严重肾动脉狭窄。讨论:巯甲丙脯氨酸治疗后发生可逆性肾功衰竭最常见的原因为失水,低血压,也可引起免
Captopril may be resistant to resistant hypertension and renal artery stenosis, whereas resistant hypertensive patients often have extensive vascular disease and some degree of renal impairment. The authors consecutively treated 22 patients with intractable hypertension with captopril and found that 3 patients experienced rapid deterioration of renal function at low doses (25-150 mg / day). All three had severe preeclampsia before vascular disease (2 with intermittent claudication had surgery and 1 with aneurysm extending beyond the renal vasculature), but none had loss of fluid, decreased blood pressure, and proteinuria And urinary retention, within one month after withdrawal, blood pressure control with other antihypertensive drugs have improved, renal full recovery, aortic angiography showed a single renal function with severe renal artery stenosis. Discussion: The most common cause of reversible renal failure after treatment with captopril is dehydration, hypotension, and may also cause