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【目的】比较血管紧张素转换酶抑制剂(angiotensin converting engyme inhibitor,ACEI)、血管紧张素Ⅱ受体拮抗剂(angiotensinⅡreceptor blocker,ARB)、钙离子阻断剂(calcium channel blocker,CCB)单独及联合使用对肾脏的保护作用及其机制。【方法】将雌性Wistar大鼠50只随机分成5组,每组10只,其中Ⅰ组为阴性对照组,Ⅱ组为5/6肾切除的阳性对照组,Ⅲ～Ⅴ分别为5/6肾切除术后给予氨氯地平(CCB)、贝那普利(ACEI)+氨氯地平(CCB)及贝那普利(ACEI)+氯沙坦治疗组(ARB)。干预时间为10周,观察治疗后大鼠的血压、蛋白尿、血红蛋白、生化指标的差异。【结果】与Ⅱ组比较,Ⅲ～Ⅴ组均能有效的控制大鼠血压,但各治疗组间疗效差异无统计学意义。Ⅴ组在降尿蛋白方面最佳,其次为Ⅳ组;术后10周,Ⅱ～Ⅴ组大鼠血BUN、Cr浓度较Ⅰ组均明显升高,但组间差异无统计学意义。Ⅳ组大鼠肾脏病理改变最轻。【结论】ACEI、ARB和CCB单独或联合治疗对肾脏均有保护作用,但联合治疗组的肾脏保护作用更好,尤以ACEI联合CCB组肾脏病理改变最轻。ACEI联合ARB治疗对减少蛋白尿作用最强。
【Objective】 To compare the effects of angiotensin converting engyme inhibitor (ACEI), angiotensin Ⅱ receptor blocker (ARB) and calcium channel blocker (CCB) alone and in combination Use of kidney protection and its mechanism. 【Methods】 Fifty female Wistar rats were randomly divided into 5 groups with 10 rats in each group. Group Ⅰ was negative control group, group Ⅱ was 5/6 nephrectomy positive control group, Ⅲ ~ Ⅴ were 5/6 kidney Amlodipine (CCB), ACEI + amlodipine (CCB) and ACEI + ARB were given after the resection. Intervention time was 10 weeks, observed after treatment, blood pressure, proteinuria, hemoglobin, biochemical differences. 【Results】 Compared with group Ⅱ, all the rats in group Ⅲ ~ Ⅴ were able to effectively control the blood pressure in rats. However, there was no significant difference in the therapeutic effect between the two groups. Group V was the best in reducing proteinuria, followed by group Ⅳ. At the 10th week after operation, the concentrations of BUN and Cr in serum of group Ⅱ ~ Ⅴ were significantly higher than those of group Ⅰ, but there was no significant difference between groups. The rats in group Ⅳ had the lightest renal pathological changes. 【Conclusion】 ACEI, ARB and CCB alone or in combination have a protective effect on the kidney, but the combination therapy group has a better protective effect on the kidneys, especially in the combination of ACEI and CCB. ACEI combined with ARB treatment to reduce proteinuria strongest.