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本文分六个方面简介抗高血压药对肾脏的影响。一、血管紧张素转化酶抑制剂(ACEI)众所周知ACEI 的效应与血管紧张素Ⅱ(AngⅡ)是密切相关的。AngⅡ对肾小球血液动力学的主要作用是收缩出球小动脉,滤过分数增加;另一方面收缩系膜细胞,降低有效超滤面积使超滤系数下降.许多原发性高血压病人有肾血管阻力RVR 的功能性增加和肾血流量RVR(RBF)降低,ACEI 和各种血管扩张剂不同,非但能逆转血管收缩,提高RBF,而且能增加肾小球滤过率(GItR),晚近认为ACEI 的作用还存在非肾素·血管紧张素系统(NRAS)机制,如抑制缓激肽降解和刺激前列
This article is divided into six aspects about the impact of antihypertensive drugs on the kidneys. First, the angiotensin-converting enzyme inhibitor (ACEI) It is well known that the effect of ACEI and angiotensin Ⅱ (Ang Ⅱ) are closely related. The primary effect of Ang II on the glomerular hemodynamics is the contraction of the arteriolar arteries, increased fractional filtration, and on the other hand the contraction of mesangial cells, reducing the effective ultrafiltration area and decreasing the ultrafiltration coefficient. Many patients with essential hypertension have Renal vascular resistance RVR increased functional and renal blood flow decreased RVR (RBF), ACEI and various vasodilators, not only can reverse the vasoconstriction, increased RBF, but also increase the glomerular filtration rate (GItR), late The role of ACEI is believed to be non-renin-angiotensin system (NRAS) mechanisms such as inhibition of bradykinin degradation and stimulation of the forefront