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引用本文:刘玉龙,舒冰.缓激肽介导的治疗心血管和糖尿病药物致血管性水肿的研究进展[J].中国现代应用药学,2020,37(22):2810-2816.
LIU Yulong,SHU Bing.Advances in the Bradykinin-mediated Angioedema Caused by Cardiovascular and Diabetic Medications[J].Chin J Mod Appl Pharm(中国现代应用药学),2020,37(22):2810-2816.
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缓激肽介导的治疗心血管和糖尿病药物致血管性水肿的研究进展
刘玉龙1, 舒冰2
1.颍上县人民医院药剂科, 安徽 阜阳 236200;2.中国科学技术大学附属第一医院(安徽省立医院)药剂科, 合肥 230001
摘要:
肾素-血管紧张素-醛固酮系统(renin-angiotensin-aldosterone system,RAAS)抑制剂诱导的血管性水肿会导致缓激肽生成增加或降解减少。二肽基肽酶Ⅳ抑制剂是一种影响缓激肽和P物质降解的口服糖尿病药物,可诱发血管性水肿。脑啡肽酶抑制剂是一种新型具有潜在改善患者心血管疾病转归的药物,与RAAS抑制剂联用增加血管性水肿的发生风险。本文针对上述药物致血管性水肿的流行病学、发生机制、临床症状及治疗进行阐述,旨在为临床安全用药提供参考。
关键词:  肾素-血管紧张素-醛固酮系统  二肽基肽酶Ⅳ抑制剂  脑啡肽酶抑制剂  缓激肽  血管性水肿
DOI:10.13748/j.cnki.issn1007-7693.2020.22.022
分类号:R969.3
基金项目:
Advances in the Bradykinin-mediated Angioedema Caused by Cardiovascular and Diabetic Medications
LIU Yulong1, SHU Bing2
1.Department of Pharmacy, The People's Hospital of Yingshang, Fuyang 236200, China;2.Department of Pharmacy, The First Hospital Affiliated to University of Science and Technology of China(Anhui Provincial Hospital), Hefei 230001, China
Abstract:
Angioedema induced by renin-angiotensin-aldosterone system(RAAS) inhibitors is the result of increased production or decreased degradation of bradykinin. Dipeptidyl peptidase IV inhibitors are a class of oral diabetic agents that affect bradykinin and substance P degradation, therefore can lead to angioedema. Neprilysin inhibitors are a new type of medications that has the potential to improve the outcome of cardiovascular disease and can further increase the risk of medication-induced angioedema especially when combined with RAAS inhibitors. This review summarizes updated information of epidemiology, mechanism, symptoms and treatment of angioedema induced by these medications, in order to provide reference for the drug use.
Key words:  renin-angiotensin-aldosterone system  dipeptidyl peptidase IV inhibitors  neprilysin inhibitors  bradykinin  angioedema
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