第24章章节作用于肾素-血管紧张素-醛固酮系统的药物-双语.pptVIP

第 24 章 肾素-血管紧张素－醛固酮系统抑制药 华中科技大学同济医学院药理学系 主讲教师 金满文 In 1898, Tiegerstedt and Bergman found that crude saline extracts of the kidney contained a pressor substance that they named renin. Tigerstedt R, Bergman PG: Niere und Kreislauf 肾脏和循环. Skand Arch Physiol 1898; 8:223-271. 。 Extrinsic Local RAAS Extrinsic Local RAAS (take up) Circulating renin of renal origin can be taken up by the arterial wall and by other tissues. 许多组织（脑、血管、心脏、肾脏、肾上腺）表达肾素、血管紧张素原、转换酶的mRNA，源于这些组织的细胞培养可产生肾素、血管紧张素原、转换酶、Ang I, II, and III. 17/70 19/70 21/70 23/70 24/70 1971年，Ondetti等*合成了tiprotide，是第一个用于临床的肽类ACEI。 一、ACE的分类和构效关系 (二)ACEI与酶的结合 27/70 30/70 ㈡抗心血管病理性重构 ㈣抗氧化作用 ACEI降低血浆脂质过氧化物浓度，对抗自由基对心脏和血管的损伤作用。 Hypertension 高血压(一线药物) ACE inhibitors alone normalize blood pressure in approximately 50% of patients with mild to moderate hypertension. 90％ of patients with mild to moderate hypertension will be controlled by the combination of an ACE inhibitor and either a Calcium channel blocker, an adrenergic receptor blocker, or a diuretic. Left Ventricular Systolic Dysfunction ACE inhibitors reduce overall mortality when treatment is begun during the peri-infarction period. The beneficia