血管紧张素转化酶抑制剂与受体阻断剂治疗慢性心力衰竭优劣性比较  

Role of angiotensin converting enzyme inhibitors and angiotensin receptor blockers in the treatment of congestive heart failure

作　　者：郑刚[1,2,3] 

机构地区：[1]天津市第三医院 [2]天津市老年病研究所 [3]天津市高血压防治中心

出　　处：《世界临床药物》2008年第10期587-590,共4页World Clinical Drug

摘　　要：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 converting enzyme inhibitors （ACEIs） and angiotensin Ⅱ receptor blockers （ARBs） can improve prognosis of patients with congestive heart failure （CHF） therefore are the treatment of choice in these patients. It is expected that the curative effect of ARBs should surpass ACEIs since ARBs inhibit RAAS more completely. On the other hand, since ARBs have no effect on bradykinin, the adverse reactions of ARBs are less than ACEIs. Combination of an ACEI and an ARB are also expected to have more effects than ACE alone. The purpose of this article is to discuss whether ARB alone or combination with ACEI are more effective than ACEI alone by reviewing the results of clinical researchs recently.

关 键 词：血管紧张素转化酶抑制剂 血管紧张素受体阻断剂 心力衰竭 慢性 临床研究 

分 类 号：R972.4[医药卫生—药品] R541.6[医药卫生—药学]