硫酸亚铁治疗血管紧张素转化酶抑制剂引起的咳嗽

Effect of Ferrous Sulfate on Angiotensin-converting Enzyme Inhibitor Induced Cough

背景 血管紧张素转化酶抑制剂 (ACEI)引起干咳的机制尚不完全清楚 ,有报道认为可能是由一氧化氮 (NO)介导的 ,而补充铁剂能减少NO的生成并能降低NO相关的细胞损害。目的 明确硫酸亚铁能否抑制ACEI引起的咳嗽。方法 4 3例ACEI引起的干咳 ,随机分成两组 ,治疗组 2 3人 ,对照组 2 0人 ,在继续服用原ACEI药物基础上治疗组给予硫酸亚铁 30 0mg/日 ,对照组给予安慰剂 ,比较用药后两周两组干咳的情况。 结果 治疗组干咳完全消失 6例 ,好转 13例 ,有效率 83% ,对照组干咳完全消失 0例 ,好转 3例 ,有效率 15 % (P <0 0 0 1)。结论 硫酸亚铁能抑制ACEI引起的咳嗽 。

Background The mechanism of angiotensin converting enzyme inhibitor (ACEI) induced cough has not been fully elucidated. One of possible mechanisms is ACEI increase nitric oxide (NO) generation, iron supplementation can inhibit this increase and NO related cell damage. Objective To determine the effect of ferrous sulfate on angiotensin converting enzyme inhibitor induced cough. Methods Forty three patients with ACEI induced cough were randomly divided into two groups. Besides continuing ACEI, treatment group ( n =23) were given ferrous sulfate 300 mg per day and control group ( n =20) were given vitamine C as placebo. Dry cough was evaluated at the end of two weeks. Results Cough was completely abolished in 6 patients in ferrous sulfate treatment group (13/23, 83%), while only 3 patients responsed to placebo(3/20, 15%). Conclusion ACEI induced cough can be inhibited by ferrous sulfate. The mechanism of the reduction of NO generation in bronchial epithelial cells is speculated an the mechanism of the effect.