Barna István
Semmelweis Egyetem, Altalános Orvostudományi Kar, I. Belgyógyászati Klinika, Budapest.
Orv Hetil. 2006 Jun 4;147(22):1019-23.
The renal impairment due to hypertension causes the disturbance of the renin-angiotensin-aldosterone system which is accompanied with increased activity of the sympathetic nervous system. Administration of angiotensin-converting enzyme inhibitors decreases the production of angiotensin II, secretion of aldosterone, sodium and water retention and peripheral vascular resistance which altogether lead to the reduction of blood pressure. The nephro-protective efficacy of angiotensin-converting enzyme inhibitors was also proved by plenty of extensive international trials both in diabetic and non-diabetic patients with renal diseases. On evidence based medicine we may consider angiotensin-converting enzyme inhibitors and angiotensin receptor blockers--provided there are no contraindications as the standard therapy in all hypertensive and renal diseases.
高血压所致的肾损害会引起肾素-血管紧张素-醛固酮系统紊乱，同时伴有交感神经系统活性增强。给予血管紧张素转换酶抑制剂可减少血管紧张素II的生成、醛固酮的分泌、钠和水潴留以及外周血管阻力，这些共同作用导致血压降低。血管紧张素转换酶抑制剂对肾脏的保护作用也在大量针对糖尿病和非糖尿病肾病患者的广泛国际试验中得到证实。基于循证医学，我们可以考虑将血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂——前提是没有禁忌证——作为所有高血压和肾脏疾病的标准治疗方法。
