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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>:You mentioned in your lecture that ACE inhibitors such as captopril and enalapril are contraindicated during pregnancy. What about the second generation ACE inhibitor trandolapril, which has recently been used clinically to treat hypertension? Is it safe for use in pregnancy?

 《国际循环》:Magee教授,在您的研究介绍中已经大略提到ACE抑制剂包括Captopril和Alipril等因对胎儿有害而孕妇禁用此类药物。是否有人对二代ACE抑制剂Trindalapil进行过胎儿毒性的研究?有没有相关资料还是根本没有开展此类研究?这两代ACE抑制剂对妊娠的作用有没有区别?

    Prof.L.Magee:The assumption is that it is a class effect. In terms of whether or not it will be studied, all of the literature is about animal studies or inadvertent first trimester exposures, with the exception of one case series that I am aware of from Seattle by Tom Easterling. Otherwise, no one has actively and knowingly given these drugs in pregnancy and they have been stopped when pregnancy is diagnosed. Animal studies are obligatory and I am not familiar with what was identified with the second generation of ACE inhibitors in animal studies but most practitioners would regard them as guilty by association with the older generation and would practice avoidance of conception on these medications and certainly avoidance of ongoing use in pregnancy.

    Magee教授: 这两代ACE抑剂可能对妊娠具有类似的作用。至于二代ACE抑制剂是否具有胎儿毒性会进行研究证实的。据我所知,除了西雅图的一个临床病例研究外,现有的研究均来自动物实验或孕早期的无意的药物接触。事实上没有人会在诊断出患者妊娠后还故意继续给予ACE抑剂,而动物实验是强制性的。我不清楚二代ACE抑制剂在动物实验的具体研究结果。但大多数医生觉得二代应该同样具有胎儿毒性,因此会在孕妇上避免使用二代ACE抑制剂。

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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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