- 作者: 蔡養德; 林漢傑; 李發耀; 侯明志; 王聖賢; 李壽東
- 作者服務機構: 台中榮民總醫院胃腸科; 台北榮民總醫院胃腸科; 國立陽明大學醫學院
- 中文摘要:
腎素—血管張力素系統在鈉離子及水分的平衡上扮演了一重要的角色。同時在肝硬化合併腹水的患者,腎素—血
管張力系統亦呈被活化的現象。理論上來看,給予血管張力素轉化?抑制劑應可改善肝硬化合併腹水患者鈉離子及水
分滯留的現象。本研究即在探討低劑量之captopril對腎功能、腎血流及血流力學的影響。研究結果顯示給予安慰劑不會
影響所測定之任何參數值。在給予低劑量之captopril後可使血漿腎素值顯著的增加,顯示所用之劑量確可抑制轉化?
之活性。然而低劑量之captopril並不會影響腎功能、腎血流及血流力學之參數。故本研究顯示單獨抑制血管張力素轉化
?,並不能改善鈉離子及水分滯留的現象。
. - 英文摘要: Renin-angiotensin system plays a prominent role in the sodium and water homeostasis. In addi-tion, activation of renin-angiotensin system frequently occurs in patients with cirrhosis and ascites. Theo-retically, administering of angiotensin converting enzyme inhibitors can enhance sodium and waterretention in cirrhotic patients with ascites. In this study, we evaluate the role of low-dose captopril onrenal function changes, renal plasma flow and hemodynamics in patients with cirrhosis and ascites. Fiftypatients are randomly assigned to receive captopril or placebo for 14 days. Renal functions, renal plasmaflow, plasma renin activity, plasma aldosterone concentration and systemic and hepatic hemodynamicsare measured before and after treatment. Our results indicate that placebo administration did not affectany of the parameter measured in this study. The finding that low-dose captopril significantly increasesplasma renin activity suggests that the dose used in this study effectively blocks the enzyme activity. How-ever, low-dose captopril does not affect renal plasma flow, renal functions and systemic and hepatic hemo-dynamics. Results in this study demonstrate that inhibition of angiotensin converting enzyme alone maynot improve sodium and water retention in cirrhotic patients with ascites.
- 中文關鍵字: renin-angiotensin system; cirrhosis; portal hypertension; renal function.
- 英文關鍵字: --