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血管紧张素转换酶抑制剂(ACEI)作为抗高血压药物已在临床广泛应用.近年发现ACEI在治疗肾脏疾病上有明显疗效,该药能控制血压,降低尿蛋白,延缓肾小球硬化.但亦发现 ACEI对肾脏有一定的毒性作用,可出现急性肾衰,也可并发肾小管一间质损害或肾小球病变.本文就ACEI在肾脏病中的治疗作用及其对肾脏的毒性作用作一综述.1 对肾脏病的治疗作用11.防治糖尿病肾病(DN)DN为糖尿病的微血管并发症,其主要病理改变为肾小球毛细血管基底膜增厚,系膜细胞及系膜基质增加,导致弥漫性或结节性肾小球硬化.ACEI通过降低肾小球高灌注及高滤过作用,促使肾小球内血流动力学恢复正常;同时可抑制肾小球系膜细胞和系膜基质增生及肾小球基膜的进一步增厚,降低肾小球基膜的通透性,使尿蛋白减少;此外,还可降低胆固醇和甘油三酯,增加高密度脂蛋白,增强
Angiotensin converting enzyme inhibitor (ACEI) as an antihypertensive drug has been widely used clinically in recent years found that ACEI has a significant effect in the treatment of kidney disease, the drug can control blood pressure, reduce urinary protein, delay glomerulosclerosis, Also found that ACEI has certain toxic effects on the kidney, there may be acute renal failure, but also may be a tubular damage or glomerular lesion.Acupuncture in the treatment of renal disease and its toxic effects on the kidney A review of the treatment of renal disease 11. The prevention and treatment of diabetic nephropathy (DN) DN is a microvascular complication of diabetes, the main pathological changes of glomerular capillary basement membrane thickening, mesangial cells and mesangial matrix increased, Leading to diffuse or nodular glomerulosclerosis.ACEI by reducing the high glomerular perfusion and hyperfiltration, to promote glomerular hemodynamics returned to normal; at the same time can inhibit mesangial cells and mesangial Matrix hyperplasia and glomerular basement membrane further thickening, reducing glomerular basement membrane permeability, reducing urinary protein; In addition, but also lower cholesterol and triglycerides, increased high-density lipoprotein, increased