国际老年医学杂志2026，Vol.47Issue(5)：590-594,5.DOI:10.3969/j.issn.1674-7593.2026.05.006
血管紧张素Ⅱ受体拮抗剂联合阿司匹林治疗老年慢性肾脏病的疗效及安全性分析
Efficacy and safety analysis of angiotensinⅡ receptor blocker combined with aspirin in elderly patients with chronic kidney disease
摘要
Abstract
Objective To investigate the efficacy and safety of angiotensin Ⅱ receptor blocker(ARB)combined with aspi-rin in elderly patients with chronic kidney disease(CKD).Methods A retrospective study was conducted on 130 elderly CKD pa-tients admitted to the department of geriatrics,First Affiliated Hospital of Air Force Medical University from September 2020 to Septem-ber 2023.Based on whether aspirin was used in combination with ARBs,patients were divided into a control group(ARB alone)and an observation group(ARB combined with aspirin),with 65 cases in each group.Changes in indicators were observed after one year of treatment.Renal function indicators[estimated glomerular filtration rate(eGFR),cystatin C]were compared before and after treat-ment.Subgroup analysis of eGFR levels was performed for patients with mild-to-moderate and severe renal impairment.Liver function indicators(alanine aminotransferase),coagulation function indicators(activated partial thromboplastin time,platelet count),and ad-verse reactions were also compared.Results After treatment,eGFR increased and cystatin C decreased in both groups.The observa-tion group had significantly higher eGFR and lower cystatin C than the control group(P<0.05).In the mild-to-moderate renal impair-ment subgroups,eGFR significantly increased after treatment in both groups(P<0.05),while no significant changes in eGFR were observed in the severe renal impairment subgroups(P>0.05).There were no statistically significant differences in liver function or co-agulation function indicators between or within groups before and after treatment(P>0.05).Six patients in the observation group expe-rienced adverse reactions(including gingival bleeding,fecal occult blood,and gastrointestinal discomfort),all of which were preventa-ble and controllable.Conclusion For elderly CKD patients with mild-to-moderate renal impairment,adding aspirin to ARB therapy can improve renal function without serious adverse effects.No further benefit was observed in elderly patients with severe CKD.These findings provide evidence for stratified management when clinicians formulate combination medication regimens for elderly CKD pa-tients,helping to achieve individualized and precise drug decisions.关键词
血管紧张素Ⅱ受体拮抗剂/阿司匹林/慢性肾脏病/疗效/安全性Key words
Angiotensin Ⅱ receptor blocker/Aspirin/Chronic kidney disease/Efficacy/Safety引用本文复制引用
贾旭钊,邓玉洁,王凯曼,刘艳..血管紧张素Ⅱ受体拮抗剂联合阿司匹林治疗老年慢性肾脏病的疗效及安全性分析[J].国际老年医学杂志,2026,47(5):590-594,5.基金项目
国家自然科学基金(82300370) （82300370）
