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[ISH2010]妊娠高血压治疗策略——L.Magee教授专访

作者:国际循环网   日期:2010/10/11 11:42:00

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<International Circulation>:OK Professor Magee, you briefly covered this in you presentation, but, and you mentioned the ACE inhibitors being contraindicated, this included Captipril and Alipril, and so on

    <International Circulation>:Perhaps, since there are many other options available then it may never be seriously researched?

 《国际循环》:假设若有其它药物可供选择,那么是不是这类ACE抑制剂就不会进行研究了?

    Prof.L.Magee:Yes, the older ones never got beyond inadvertent use and it became obvious that there was fetal toxicity associated with them. The issue of whether or not they were teratogenic was possible and now we have higher quality data that suggests they are teratogenic. One thing to note however is that these drugs such as captopril, enalapril and quinopril, like most drugs, are acceptable for use in breast feeding. It is important for people to remember that because post-partum hypertension is a real problem and ACE inhibitors are very effective and we have a limited armamentarium of medications that we can feel comfortable with using. Therefore, it is important that it can be used for troublesome hypertension during breast feeding and also patients who require ACE inhibitors because of underlying renal disease or microalbuminuria from diabetes get back on their renal protective therapy right away and not delay until they are finished breastfeeding.

    Magee教授:是的,并且一代ACE抑制剂的临床使用并未出现疏忽。而且其胎儿毒性也越发显著。但问题是,它们是否有致畸性,是否导致出生缺陷,这需要重新确认。目前我们掌握了更多更有效的数据证实它们可能真的具有致畸作用。有一点需要注意,哺乳期是可以使用 Captopril, Alipril和 Trandolapri等ACE抑制剂,并且人们需要记住,产后高血压是严重的,而ACE抑制剂是有效的治疗药物。因此ACE抑剂可用于治疗复杂的高血压,此外肾脏疾病或糖尿病微量蛋白血尿的患者也可以使用ACE抑制剂。一旦患者生产完,应立即进行护肾治疗而不是等到3,6,12个月或更长的哺乳期结束后才开始治疗。

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妊娠高血压ACE抑制剂治疗策略L.Magee教授

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