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两个是否比一个更好？血管紧张素转换酶抑制剂加血管紧张素受体阻滞剂用于降低肾病患者的血压和蛋白尿

Are two better than one? Angiotensin-converting enzyme inhibitors plus angiotensin receptor blockers for reducing blood pressure and proteinuria in kidney disease.

作者信息

Linas Stuart L

机构信息

Department of Internal Medicine, Division of Renal Diseases and Hypertension, University of Colorado Health Sciences Center, Denver, Colorado 80204, USA.

出版信息

Clin J Am Soc Nephrol. 2008 Jan;3 Suppl 1(Suppl 1):S17-23. doi: 10.2215/CJN.03270807.

DOI:10.2215/CJN.03270807
PMID:18178792
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3152269/
Abstract

Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers each reduce proteinuria and blood pressure. Several studies have compared the antiproteinuric and antihypertensive effects of combination therapy with angiotensin-converting enzyme inhibitors and angiotensin receptor blockers with those of therapy with either drug class alone. This article reviews those trials as well as evidence suggesting a mechanism for the benefits observed with combination therapy.

摘要

血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂均可降低蛋白尿和血压。多项研究比较了血管紧张素转换酶抑制剂与血管紧张素受体阻滞剂联合治疗的抗蛋白尿和降压效果与单独使用这两类药物治疗的效果。本文回顾了这些试验以及提示联合治疗获益机制的证据。

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本文引用的文献

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Combination therapy with an angiotensin receptor blocker and an ACE inhibitor in proteinuric renal disease: a systematic review of the efficacy and safety data.血管紧张素受体阻滞剂与ACE抑制剂联合治疗蛋白尿性肾病：疗效和安全性数据的系统评价
Am J Kidney Dis. 2006 Jul;48(1):8-20. doi: 10.1053/j.ajkd.2006.04.077.
2
Targeting albumin excretion rate in the treatment of the hypertensive diabetic patient with renal disease.
J Am Soc Nephrol. 2005 Mar;16 Suppl 1:S42-7. doi: 10.1681/asn.2004110973.
3
Systematic review of combined angiotensin-converting enzyme inhibition and angiotensin receptor blockade in hypertension.高血压中血管紧张素转换酶抑制与血管紧张素受体阻滞剂联合应用的系统评价
Hypertension. 2005 May;45(5):880-6. doi: 10.1161/01.HYP.0000161880.59963.da. Epub 2005 Apr 4.
4
Diuretic and enhanced sodium restriction results in improved antiproteinuric response to RAS blocking agents.利尿剂与强化钠限制可增强对RAS阻断剂的抗蛋白尿反应。
J Am Soc Nephrol. 2005 Feb;16(2):474-81. doi: 10.1681/ASN.2004060505. Epub 2004 Dec 22.
5
Dual blockade of the renin-angiotensin system versus maximal recommended dose of ACE inhibition in diabetic nephropathy.肾素-血管紧张素系统双重阻断与糖尿病肾病中血管紧张素转换酶抑制剂最大推荐剂量的比较
Kidney Int. 2003 May;63(5):1874-80. doi: 10.1046/j.1523-1755.2003.00940.x.
6
Additive effect of ACE inhibition and angiotensin II receptor blockade in type I diabetic patients with diabetic nephropathy.血管紧张素转换酶抑制与血管紧张素II受体阻断对I型糖尿病肾病患者的相加作用。
J Am Soc Nephrol. 2003 Apr;14(4):992-9. doi: 10.1097/01.asn.0000054495.96193.bf.
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Effects of combined ACE inhibitor and angiotensin II antagonist treatment in human chronic nephropathies.血管紧张素转换酶抑制剂与血管紧张素II拮抗剂联合治疗对人类慢性肾病的影响。
Kidney Int. 2003 Mar;63(3):1094-103. doi: 10.1046/j.1523-1755.2003.00832.x.
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Lancet. 2003 Jan 11;361(9352):117-24. doi: 10.1016/S0140-6736(03)12229-5.
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Angiotensin II receptor blockade: is there truly a benefit of adding an ACE inhibitor?血管紧张素II受体阻滞剂：加用血管紧张素转换酶抑制剂真的有益吗？
Hypertension. 2003 Jan;41(1):31-6. doi: 10.1161/01.hyp.0000047512.58862.a9.
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Dual renin-angiotensin system blockade at optimal doses for proteinuria.以最佳剂量进行双重肾素-血管紧张素系统阻断治疗蛋白尿。
Kidney Int. 2002 Sep;62(3):1020-5. doi: 10.1046/j.1523-1755.2002.00536.x.