肾素-血管紧张素系统在儿童膀胱尿道功能障碍中的作用研究进展

Role and treatment advances of renin-angiotensin system in children with vesicourethral dysfunction

膀胱尿道功能障碍临床表现各异,部分患者治疗效果不佳(尤其是神经源性膀胱患者),后期可引起各种严重的并发症,甚至可引起致死性肾功能衰竭。肾素-血管紧张素系统(renin-angiotensin system,RAS)尤其是局部RAS在炎症及器官重塑等方面的作用已被证实,相关研究表明,RAS抑制剂(包括ACEI和ARBs)和新近发现的拮抗轴ACE2-Ang(1-7)-Mas轴具有改善下尿路功能和组织保护等功能。本文主要就ACE-AngⅡ-AT1轴和ACE2-Ang(1-7)-Mas轴在膀胱尿道功能障碍及其相关并发症的作用进行综述,探讨泌尿系统局部RAS作为儿童膀胱尿道功能障碍及其相关并发症药物治疗新靶点的可行性。

The clinical symptoms of vesicourethral dysfunction vary greatly in children.Sometimes the treatments are ineffective.Thus,various severe complications and even fatal kidney failure appears.The role of renin-angiotensin system(RAS),especially local RAS,has been well-known in inflammation and organ remodeling.RAS inhibitors(including ACEI&ARBs)and ACE2-Ang(1-7)-Mas axis,a newly discovered antagonistic axis,have the functions of relieving lower urinary tract symptoms and offering tissue protection.For exploring the possibility of local renin-angiotensin system in urinary tract as a new target for drug therapy of vesicourethral dysfunction and its related complications in children,this review focused upon the role of ACE-AngⅡ-AT1/ACE2-ang(1-7)-Mas axis in vesicourethral dysfunction as well as its complications.