卡托普利(Captopril,Capt)是第一个人工合成的口服有效的血管紧张素Ⅰ转化酶抑制剂.通过阻滞肾素一血管紧张素—醛固酮系统而发挥其药理作用.目前用于治疗高血压及心力衰竭等.随着临床用途日益扩大,各种不良反应的报道也渐增多.有关报道主要综述了国外Capt使用中一些常见的不良反应.如:皮疹、剧咳、高血钾、血管性水肿、肾病综合征、低血压等.本文就国内近几年使用Capt中所发生的特殊不良反应简述如下.1 Capt首剂综合征3例患者因高血压及心肌梗塞使用Capt.入院查体:血压22.6/14.6～13.3/9.3kPa(170/110～100/70mmHg),脉搏100～80次/min,神清,呼吸平稳,双肺无罗音,心界不大,律齐.首剂Capt6.25mg,30分钟～60分钟后,患者出现多汗,心悸,胸闷,气短,面色苍白,血压降至9.3/6.6～7.9/3.9kPa(70/50～60/30mmHg),立即给予吸氧,静注多巴胺,抢救治疗,持续用药10～12 小时后血压回升趋于稳定.Capt引起低血压等多有报道,但主要与使用剂量及服药时间较长有关,而该例是以最小剂量首次使用即发生严重不良反应.提示,临床首次使用Capt时要密切注意病情变化.2 Capt引起血透患者不良反应 Captopril (Capt) is the first synthetic, orally active, inhibitor of angiotensin I converting enzyme that exerts its pharmacological effects by blocking the renin-angiotensin-aldosterone system and is currently used to treat Hypertension and heart failure, etc .. With the increasing clinical use, the reports of various adverse reactions are also increasing.Report mainly reports some common adverse reactions in the use of Capt abroad, such as rash, acute cough, hyperkalemia, Angioedema, nephrotic syndrome, hypotension, etc .. This article on the domestic use of Capt in recent years, the occurrence of special adverse reactions are summarized as follows: 1 Capt first syndrome in 3 patients with hypertension and myocardial infarction using Capt admission Examination: blood pressure 22.6 / 14.6 ~ 13.3 / 9.3kPa (170/110 ~ 100 / 70mmHg), pulse 100 ~ 80 times / min, Shen Qing, stable breathing, lungs without rales, heart is not big, law Qi. The first dose Capt6.25mg, 30 minutes to 60 minutes, patients with hyperhidrosis, heart palpitations, chest tightness, shortness of breath, pale, blood pressure dropped to 9.3 / 6.6 ~ 7.9 / 3.9kPa (70/50 ~ 60 / 30mmHg) Oxygen, intravenous injection of dopamine, rescue treatment, continuous medication 10 to 12 hours after the blood pressure rose to stabilize .C Apt caused by hypotension and other more reports, but mainly with the use of dose and taking a longer time-related, but this case is the first time using the minimum dose of serious adverse reactions, suggesting that the first clinical use of Capt should pay close attention to changes in condition.2 Capt causes adverse reactions in hemodialysis patients