Objective To compare the clinical curative effects between the angiotensin converting enzyme inhibitor (ACEI) and angiotensin receptor blocker (ARB) in the treatment of chronic kidney disease. Methods 100 cases with chronic kidney disease from 2009 to 2012 were chosen and divided into three groups, patients in Jia group were treated with ACEI, patients in Yi group were treated with ARB, ACEI combined with ARB were used in Bing group. Except for medicines, other treatment and nursing measures were the same in three groups. After 3 months of treatment, 24 hour urine protein, serum creatinine values (Scr), serum urea nitrogen (BUN), endogenous creatinine clearance rate, cystcoming from in C (CysC) and potassium content were detected, the improvement of CKD and side effects of the drugs were compared. Results 24 hour urine protein, Scr, BUN, Ccr, CysC were all lower 3 months after the treatment in three groups than those before the treatment, the differences were all statistically significant (all P < 0.05), the differences of each index in 3 groups 3 months after the treatment were not statistically significant (P > 0.05). Conclusion Both ACEI and ARB have good clinical effect on the treatment of CKD patients' proteinuria.%目的 对血管紧张素转换酶抑制剂(angiotesion converting enzyme inhibitors,ACEI)和血管紧张素受体阻滞剂(ARB)在治疗慢性肾脏疾病(chronic kidney disease,CKD)中的临床疗效进行比较.方法 选择2009年～2012年接受CKD治疗的患者100例,随机分为三组,甲组应用ACEI类药物进行治疗;乙组应用ARB类药物进行治疗;丙组应用ACEI类和ARB联合治疗.三组除药物外,其他治疗及护理措施保持一致,检测患者治疗前及治疗后3个月的24 h尿蛋白、血肌酐值(serum creatinine,Scr)、血清尿素氮(blood urea nitrogen,BUN)、内生肌酐清除率(endogenous creatinine clearance rate,Ccr)以及血清胱抑素C(CysC)以及血钾含量,比较三组患者CKD的改善以及药物的副作用情况.结果 三组患者的24 h尿蛋白、Scr、BUN、Ccr、CysC水平治疗后3个月较治疗前明显下降,差异均有统计学意义(均P ＜ 0.05);治疗后3个月三组间各指标水平差异无统计学意义(P > 0.05).三组患者治疗后3个月不良反应发生情况差异无统计学意义(P > 0.05).结论 ACEI和ARB在治疗CKD患者蛋白尿上均有良好的临床效果,两者无明显差别.
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