巯甲丙脯酸(Captopril,以下称CPT)是口服血管紧张素转换酶抑制剂.1977年由美国Ondetti等首先合成,应用于治疗高血压.1979年我国也合成生产.目前临床应用日趋广泛,对于治疗肾性高血压、顽固性高血压和难治性心力衰竭均取得了良好的疗效,但也出现了一些不良反应,应引起临床重视、本文仅对CPT 治疗肾性高血压的作用机理及临床用药时应注意的几个问题,综述如下.一、作用机理肾性高血压的发生,从矫枉失衡学说的观点来看,是一种代偿机制,目的是维持肾血流量(RPF),因此降压后必将影响肾单位的灌注而加重氮质血症.而既往所用的任何一种降压药,均不能提高RPF 和肾小球滤过率(GFR),而CPT 在正常人和 Captopril (hereinafter referred to as CPT) is an oral angiotensin-converting enzyme inhibitor .1977 by the United States Ondetti first synthesized for the treatment of hypertension in China in 1979 is also the synthesis of production .Current clinical application is more extensive, For the treatment of renal hypertension, intractable hypertension and refractory heart failure have achieved good results, but there are also some adverse reactions, should cause clinical attention, this paper only for the treatment of renal hypertension in CPT mechanism and A few of the issues that should be noted when clinical medication, are summarized as follows: First, the mechanism of action The occurrence of renal hypertension, from the point of view of the theory of imbalance and imbalance is a compensatory mechanism aimed at maintaining renal blood flow (RPF) , So after decompression will affect the perfusion of nephrons and aggravate azotemia.Any previous antihypertensive drugs, can not improve the RPF and glomerular filtration rate (GFR), and CPT in normal people with