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肾素-血管紧张素系统(RAS)是维持内环境稳定的一个复杂的级联系统,该系统过量表达会导致心血管疾病发生。抑制血管紧张素转化酶(ACE)和血管紧张素Ⅱ的Ⅰ型受体(AT1R)可降低心血管事件发生率和病死率。基于RAS抑制剂对心血管疾病的治疗作用,考虑RAS抑制剂有可能降低心肌血管重建术后缺血性事件的发生。然而,有关心肌血管重建术后冠脉血管再狭窄或再闭塞方面的研究数据并不一致。在多数研究中,血管紧张素转化酶抑制剂(ACEI)并不能降低心肌血管重建术后再狭窄的发生,相反,ACEI甚至与经皮冠脉介入(PCI)治疗后的再狭窄率升高有关;但选择性AT1R拮抗剂能降低PCI后的支架再狭窄。
The renin-angiotensin system (RAS) is a complex cascade of systems that maintains homeostasis and over-expression of this system can lead to cardiovascular disease. Inhibition of angiotensin-converting enzyme (ACE) and angiotensin II type I receptor (AT1R) can reduce the incidence of cardiovascular events and mortality. Based on the therapeutic effect of RAS inhibitors on cardiovascular diseases, the consideration of RAS inhibitors may reduce the occurrence of ischemic events after myocardial revascularization. However, data on coronary vascular restenosis or reocclusion after myocardial revascularization are inconsistent. In most studies, angiotensin-converting enzyme inhibitors (ACEIs) did not reduce restenosis after myocardial revascularization. In contrast, ACEI was associated with an even higher rate of restenosis after percutaneous coronary intervention (PCI) ; But selective AT1R antagonists reduce stent restenosis after PCI.