Lipid peroxides and fluorescent serum proteins, possible markers of free radical activity, are increased in diabetic patients, particularly those with angiopathy. Captopril, an angiotensin converting enzyme (ACE) inhibitor, scavenges free radicals in vitro independently of ACE inhibition. This is probably due to the presence of a sulphydryl group which is not present in other ACE inhibitor drugs. We have compared the effects of captopril and enalapril on free radical activity in thirty-two diabetic subjects with hypertension (BP greater than 160/95 mmHg). After a three week run-in period on no antihypertensive therapy, patients were randomly allocated to receive captopril or enalapril, the dose titrated according to BP response. After three months, BP was well controlled in both groups and glycaemic control unchanged. Both drugs were associated with a reduction of fluorescent IgG (captopril:Baseline [BL] 0.564 vs. 12 weeks [w] 0.428, P less than 0.05, enalapril:BL 0.603 vs. 12w 0.422 P less than 0.05) and thiobarbituric acid reactive material (captopril:BL 2.35 nmol MDA vs. 12w 1.46 nmol, P less than 0.05, enalapril:BL 2.44 nmol vs. 12w 1.72 nmol, P less than 0.01). In contrast to in vitro studies, there was no significant difference between the drugs when used in therapeutic doses, questioning a hypothesised advantage of captopril over enalapril.

译文

:脂质过氧化物和荧光血清蛋白,可能是自由基活性的标志物,在糖尿病患者,特别是患有血管病的患者中增加。卡托普利是一种血管紧张素转化酶(ACE)抑制剂,可在体外独立于ACE抑制清除自由基。这可能是由于存在其他ACE抑制剂药物中不存在的巯基。我们已经比较了卡托普利和依那普利对32例高血压糖尿病患者的自由基活性的影响(血压大于160/95 mmHg)。经过三周的不使用降压疗法的磨合期后,患者被随机分配接受卡托普利或依那普利治疗,剂量根据BP反应而调整。三个月后,两组血压均得到良好控制,血糖控制未改变。两种药物均与荧光IgG(卡托普利:基线[BL] 0.564比12周[w] 0.428,P小于0.05,依那普利:BL 0.603与12w 0.422 P小于0.05)降低有关,并且硫代巴比妥酸反应性物质减少(卡托普利:BL 2.35 nmol MDA与12w 1.46 nmol,P小于0.05,依那普利:BL 2.44 nmol与12w 1.72 nmol,P小于0.01)。与体外研究相反,当以治疗剂量使用时,两种药物之间没有显着差异,这质疑了卡托普利相对于依那普利的假设优势。

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