[ACEi和ARBs:蛋白尿症抑制和脏保护]
Filippo Aucella1, Rachele Grifa1, Francesco Aucella1
1Dipartimento di Scienze Mediche, S.C. di Nefrologia e Dialisi, Fondazione "Casa Sollievo della Sofferenza", IRCCS, San Giovanni Rotondo (FG), Italy.
概括
氨酸- ангиотензин- алдостерон系统 (RAAS) 在脏和心脏疾病中至关重要. 用ACEI/ARB抑制RAAS可提供脏保护,降低血压和白尿,以获得更好的长期脏结果.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 心脏病学 心脏病学
- 药理学 药理学是指药理学的学科.
背景情况:
- 氨酸- ангиотензин- алдостерон (RAAS) 系统显著影响脏和心血管健康.
- 增加RAAS活性与高血压,心力衰竭和病进展有关.
- ACE 抑制剂 (ACEI) 和血管激素二受体阻断剂 (ARB) 对于管理这些疾病至关重要.
研究的目的:
- 要突出ACEI和ARB的脏保护作用.
- 在慢性病 (CKD) 患者中讨论优化RAAS抑制策略.
- 强调RAAS抑制在晚期CKD中的重要性.
主要方法:
- 关于RAAS抑制剂在脏和心血管疾病中的当前文献的综述.
- 分析ACEI和ARB对血压和白蛋白尿的影响.
- 影响RAAS抑制功效的因素的评估,包括盐摄入量和剂量.
主要成果:
- ACEI和ARB可以降低血压和白蛋白尿,减轻心血管损伤和CKD进展.
- 最初的EGFR降低高达30%可以表明成功的长期脏保护.
- 最佳的抗蛋白尿效应可能需要比用于高血压的剂量更高的剂量.
结论:
- 严格控制盐摄入量和可能更高的有效剂量对于优化RAAS抑制至关重要.
- 在选择的监测患者中,可以考虑双重RAAS阻塞.
- 在晚期的CKD中,应继续抑制RAAS,以控制心血管风险,并可能保持GFR.
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