中国临床医学2011，Vol.18Issue(4)：427-429,3.
血管紧张素Ⅱ受体阻断剂对慢性肾脏病患者肾素-血管紧张素系统表达的影响
The Effect of Angiotensin Ⅱ Receptor Blocker on Renin-Angiotensin System in Chronic Kidney Disease Patients
摘要
Abstract
Objective:To analyze the effect of angiotensin Ⅱ receptor blocker(ARB) on renin-angiotensin systemCRAS) in chronic kidney disease(CKD) patients. Methods: Among CKD patients who performed renal biopsy in Shanghai Zhongshan Hospital and had not received angiotensin converting enzyme inhibitor during last 2 months, 17 patients had received ARB during last two weeks (ARB group). They were matched pair with other patients who had not received ARB during last two weeks according to age, sex, blood pressure, estimated glomerular filtration rate (eGFR) , urinary protein of 24 hours and urinary sodium (control group). We measured plasma renin activity, plasma and urinary angiotensinogenC AGT), angiotensin Ⅱ (AngⅡ ) and aldosterone by RIA or ELISA and assessed expression of intrarenal renin, AGT, Ang Ⅱ and angiotensinⅡ receptor by immunohistochemistry staining(IHCS) in order to determine the difference of general and intrarenal RAS activity between two groups. Results: There was no difference on sex, age, blood pressure, eGFR, urinary protein of 24 hours and urinary sodium between two groups. Average plasma Ang Ⅱin ARB group was higher than that in control group (63. 09 ± 15. 14 pg/mL vs. 53. 66 ±8. 33 pg/mL, P<0. 05). Positive IHCS area of intrarenal renin in ARB group was higher than that in control group (48. 65% ± 19. 58% vs. 30. 29% ± 24. 98% ,P<0. 05). Positive IHCS area of intrarenal AGT, Ang Ⅱ and angiotensinⅡ type 1 receptor in ARB group was lower than those in control group, but the difference had no statistical meaning. Conclusions: ARB has different influence on the activity of general and intrarenal RAS. ARB can elevate general angiotensin II activity and probably can inhibit the expression of intrarenal angiotensin Ⅱ .关键词
血管紧张素Ⅱ受体阻断剂/肾素/血管紧张素Ⅱ/肾脏肾素-血管紧张素系统Key words
Angiotensin Ⅱ receptor blocker/Renin/Angiotensin Ⅱ /Renin-angiotensin system分类
医药卫生引用本文复制引用
章晓燕,吕文律,许迅辉,滕杰,钟一红,丁小强..血管紧张素Ⅱ受体阻断剂对慢性肾脏病患者肾素-血管紧张素系统表达的影响[J].中国临床医学,2011,18(4):427-429,3.基金项目
上海市科委重大项目(编号:08dz1900602),教育部重点学科211重大项目(编号:211XK20) （编号:08dz1900602）
