Ritz E, Nowack R, Reisch C, Beutel G
Medizinische Universitätsklinik Heidelberg.
Klin Wochenschr. 1991;69 Suppl 24:50-7; discussion 57-8.
Recently it has been recognized that even minor elevations of blood pressure contribute to progression of renal failure. Furthermore it has been documented that antihypertensive treatment retards progression of renal failure. Despite impressive experimental data firm clinical evidence, incontrovertible on biostatistical grounds, is not yet available to document that converting enzyme inhibitors (CEI) are superior to alternative antihypertensive agents with respect to halting progression. CEI undoubtedly reduce albuminuria, independent of their effect on systemic blood pressure, and this is related to alterations of glomerular permeability. Recent experimental data suggest that growth processes in damaged kidneys are an important aspect of progression. It is a fascinating perspective, but yet unproven, that CEI interfere with these processes.
最近人们认识到,即使血压轻微升高也会促使肾衰竭进展。此外,已有文献记载抗高血压治疗可延缓肾衰竭进展。尽管有令人印象深刻的实验数据,但尚无基于生物统计学无可争议的确凿临床证据来证明,在阻止疾病进展方面,转换酶抑制剂(CEI)优于其他抗高血压药物。CEI无疑可减少蛋白尿,这与其对全身血压的影响无关,且这与肾小球通透性的改变有关。最近的实验数据表明,受损肾脏中的生长过程是疾病进展的一个重要方面。CEI会干扰这些过程,这是一个引人入胜的观点,但尚未得到证实。