血管紧张素转化酶抑制剂用于卒中预防研究  

Angiotensin-converting Enzyme Inhibitor for Prevention of Stroke

作　　者：余桂军[1] 任传成[1] 周玲[1] 倪冬艳[1] 

机构地区：[1]复旦大学附属上海市第五人民医院神经内科,200240

出　　处：《中国临床神经科学》2006年第1期101-105,共5页Chinese Journal of Clinical Neurosciences

摘　　要：卒中是导致病人死亡及致残的重要原因,而卒中预防措施的临床应用证据尚有很大差异。1998年以来有关ACE抑制剂对卒中一级和二级预防随机对照的文献已证明其能有效预防卒中,卒中一级预防这种作用和利尿剂、β阻滞剂和钙阻滞剂相似。ACE抑制剂有效预防卒中的机制可能和其稳定内皮细胞功能、增强内源性纤维蛋白溶解、减少氧化过程及抑制增生和炎症反应等作用有关,这可在稳定动脉粥样硬化斑块中产生有益作用。Stroke is a major cause of mortality and morbidity, and the application of evidence for stroke prevention varies considerably. In searches of MEDLINE, we performed to identify English-language articles published from 1998 that focused on primary and secondary stroke prevention with ACE inhibitor,and further to analyze. The benefit of antihypertensive therapy in the primary prevention of stroke, a mate-analysis of placebo-controlled trials of ACE inhibitor in patients with coronary, heart disease and/or diabetes mellitus, the overall risk of stroke was significantly reduced. In active-control comparisons in patients with hypertension, ACE inhibitors have demonstrated reductions in primary stroke risk similar to reductions with diuretics, β-blockers, and calcium channel blockers. The benefit of antihypertensive therapy in the secondary prevention of stroke, the Perindopril Protection Against Recurrent Stroke Study （PROGRESS） trial found that a combination of ACE inhibitor and diuretic lowered blood pressure and effective reduced stroke risk. This benefit occurred in patients with and without hypertension. The protective effects of ACE inhibitor on the vascular wall are possibly explained by decreased oxidative stress and decreased proliferated and inflammatory responses resulting in a beneficial effect on the progression of atherosclerotic plaques. ACE inhibitor was very safe and tolerated over the long-term follow-up period.

关 键 词：血管紧张素转化酶抑制剂 卒中 预防 

分 类 号：R743[医药卫生—神经病学与精神病学] R741.05[医药卫生—临床医学]