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血管紧张素受体阻断剂(ARB)在受体水平上发挥作用,可更完全地阻断肾素-血管紧张素-醛固酮系统(RAAS),其疗效优于血管紧张素转化酶抑制剂(ACEI)。ARB不影响缓激肽系统,因而无类似ACEI的不良反应,安全性可与安慰剂比拟。ARB是否可替代ACEI或与ACEI联合用于慢性心力衰竭(CHF)治疗的探讨,引出CHF患者应首选ACEI还是ARB的争论。本文通过对临床研究证据的回顾,辨别ACEI与ARB对CHF患者治疗的优劣,验证联合用药的疗效。
Angiotensin receptor blockers (ARBs) act at the receptor level to more completely block the renin-angiotensin-aldosterone system (RAAS) and are superior to angiotensin-converting enzyme inhibitors ACEI). ARB does not affect the bradykinin system, and therefore no ACEI-like adverse reactions, safety and placebo comparable. Whether ARB can replace ACEI or combined with ACEI in the treatment of chronic heart failure (CHF), leading to CHF patients should be the preferred ACEI or ARB controversy. This article reviews the evidence of clinical studies to identify the advantages and disadvantages of ACEI and ARB treatment of CHF patients to verify the efficacy of combination therapy.