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Ðå§þ¬å. Îá®áùåí» ±®â°å¬åíí»å ﮫ®¦åíèÿ ® ê«à±±èôèêàöèè, ¬åµàí觬ൠ°à§âèòèÿ è òàêòèêå ê®°°åêöèè íåô°®-
ãåíí®© à°òå°èà«üí®© ãèïå°òåí§èè (ÀÃ). Ðà±±¬®ò°åíà °®«ü ã嬮¤èíà¬è·å±êèµ è íåã嬮¤èíà¬è·å±êèµ ôàêò®°®â â
ïàò®ãåíå§å ï®â»øåíèÿ à°òå°èà«üí®ã® ¤àâ«åíèÿ ó ïàöèåíò®â ± ïà°åíµè¬àò®§í»¬è §à᮫åâàíèÿ¬è ï®·åê. α®á®å
âíè¬àíèå ó¤å«åí® ê®¬ï®íåíòଠ°åíèí-àíãè®òåí§èí®â®© ±è±ò嬻, ó·à±òâóþùè¬ â ï°®«èôå°àöèè ¬å§àíãèÿ, â৮-
ê®í±ò°èêöèè, ã«®¬å°ó«ÿ°í®© êàïè««ÿ°í®© ãèïå°òåí§èè, ï°®ã°å±±è°®âàíèè ï®·å·í®© í央±òàò®·í®±òè. ϰ失òàâ-
«åí» òå®°åòè·å±êèå ï°å¤ï®±»«êè è ê«èíè·å±êèå ï®êà§àíèÿ ¤«ÿ «å·åíèÿ Àà ó ᮫üí»µ íåô°®«®ãè·å±ê®ã® ï°®ôè«ÿ ±
è±ï®«ü§®âàíèå¬ èíãèáèò®°®â àíãè®òåí§èíï°åâ°àùàþùåã® ôå°¬åíòà (ÀÏ”), àíòàã®íè±ò®â °åöåïò®°®â àíãè®òåí-
§èíà II, àíòàã®íè±ò®â êà«üöèÿ. „àí® ïàò®ãåíåòè·å±ê®å ®á®±í®âàíèå â«èÿíèÿ ýòèµ ï°åïà°àò®â íà ±è±òå¬íóþ è
âíóò°èê«óá®·ê®âóþ ãèïå°òåí§èþ, íàò°è©ó°å§, ±èíòå§ à«ü¤®±òå°®íà. Íà°ÿ¤ó ± è§âå±òí»¬è àíòèãèïå°òåí§èâí»-
¬è ±â®©±òâà¬è ®±âåùåí» íå¤àâí® â»ÿâ«åíí»å àíòèï°®òåèíó°è·å±êèå è °åí®ï°®òåêò®°í»å ýôôåêò» èíãèáèò®-
°®â ÀÏ”, àíòàã®íè±ò®â °åöåïò®°®â àíãè®òåí§èíà II, ·ò® §íà·èòå«üí® °à±øè°ÿåò ê°óã òå°àïåâòè·å±ê®ã® ï°è-
¬åíåíèÿ ýòèµ «åêà°±òâåíí»µ ±°å¤±òâ â íåô°®«®ãèè.
Ê«þ·åâ»å ±«®âà: °åí®ïà°åíµè¬àò®§íàÿ à°òå°èà«üíàÿ ãèïå°òåí§èÿ, °åíèí-àíãè®òåí§èí®âàÿ ±è±òå¬à, èíãèáèò®-
°» àíãè®òåí§èíï°åâ°àùàþùåã® ôå°¬åíòà, àíòàã®íè±ò» °åöåïò®°®â àíãè®òåí§èíà II, àíòàã®íè±ò» êà«üöèÿ.



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À°òå°èà«üíàÿ ãèïå°òåí§èÿ (ÀÃ) ·à±ò® ÿâ«ÿåò±ÿ
Ê«à±±èôèêàöèÿ ±è¬ïò®¬àòè·å±ê®© ÀÃ
±®ïóò±òâóþùå© ïàò®«®ãèå© ï°è §à᮫åâàíèÿµ ï®·åê, ï°è ïàò®«®ãèè ï®·åê è ï®·å·í»µ ±®±ó¤®â
òàê êàê è¬åíí® ï®·êè ÿâ«ÿþò±ÿ íàè᮫åå âà¦í»¬ À°òå°èà«üíàÿ ãèïå°òåí§èÿ Ïàò®«®ãè·å±êèå ±®±ò®ÿíèÿ
®°ãàí®¬ â °åãó«ÿöèè à°òå°èà«üí®ã® ¤àâ«åíèÿ (À„). Ðåí®ïà°åíµè¬àò®§íàÿ αò°»© è µ°®íè·å±êè© ã«®¬å°ó«®íåô°èò,
ïèå«®íåô°èò, ¤èàáåòè·å±êàÿ íåô°®ïàòèÿ,
Ê°®¬å ò®ã®, ·ò® ï®·êè ê®íò°®«è°óþò âíåê«åò®·í»©
èíòå°±òèöèà«üí»© íåô°èò, íåô°®ïàòèÿ
®áúå¬ ¦è¤ê®±òè è ®áùåå ±®¤å°¦àíèå íàò°èÿ è ý«åêò- áå°å¬åíí»µ, ±è±òå¬í»å §à᮫åâàíèÿ
°®«èò®â â ®°ãàí觬å, ®íè ï°®¤óöè°óþò òàêèå â৮- ±®å¤èíèòå«üí®© òêàíè
Ðåí®âà±êó«ÿ°íàÿ À°òå°èà«üíàÿ. —à±ò»å §à᮫åâàíèÿ:
ê®í±ò°èêò®°í»å ±óá±òàíöèè, êàê °åíèí, ýí¤®òå«èí,
àòå°®±ê«å°®§, ôèá°®¬ó±êó«ÿ°íàÿ
ï°®±òàã«àí¤èí … è â৮¤è«àòàò®°» ” ®ê±è¤ ৮òà, ¤è±ï«à§èÿ ï®·å·í»µ à°òå°è©
ï°®±òàã«àí¤èí F1± è êèíèí». ‘«å¤®âàòå«üí®, ï®·- Ðå¤êèå §à᮫åâàíèÿ: à®°ò®à°òå°èèò,
àíåâ°è§¬», ò°®¬á®§» è ý¬á®«èè ï®·å·í»µ
êè ®òâåò±òâåíí» êàê §à ê®íò°®«ü ®áúå¬à ¦è¤ê®±òè è
à°òå°è©, ò°à⬻ ± ï®â°å¦¤åíèå¬ ï®·å·-
ó°®âíÿ ý«åêò°®«èò®â, òàê è §à ±®±ò®ÿíèå ïå°èôå°è- í»µ à°òå°è©, ó§å«ê®â»© ïå°èà°òå°èèò,
·å±ê®ã® ±®±ó¤è±ò®ã® ±®ï°®òèâ«åíèÿ [2, 4]. íå©°®ôèá°®¬àò®§, àí®¬à«èè °à§âèòèÿ
à°òå°è©, ᮫å§íü ’àêàÿ±ó
Ï°è·èí®© ãèïå°òåí§èâí®ã® ï®·å·í®ã® ±èí¤°®-
‚åí®§íàÿ: ò°®¬á®§ ï®·å·í®© âåí»,
¬à ¬®ãóò á»òü ¬í®ãèå §à᮫åâàíèÿ, ê®ò®°»å °à§¤å- àí®¬à«èÿ ï®·å·í®© âåí»,
«åí» íà ò°è ã°óïï», à â ï®±«å¤íèå 㮤» ⻤å«ÿþò °åò°®ïå°èò®íåà«üí»© ôèá°®§, íåô°®ïò®§
‘¬åøàííàÿ Ï®«èêè±ò®§ ï®·åê, ®ï󵮫ü, êè±òà ï®·êè,
òàê¦å ï®±òò°àí±ï«àíòàöè®ííóþ Àà (òàá«èöà).
ã褰®íåô°®§, òóáå°êó«å§, «öå««®ôàí®âàÿ
À¬å°èêàí±êèå êత讫®ãè ¤å«ÿò §à᮫åâàíèÿ ï®·êà» (êàê ±«å¤±òâèå ò°àâ¬, ïå°èíåô°èòà)
ï®·åê, ê®ò®°»å ÿâ«ÿþò±ÿ ï°è·èí®© ±è¬ïò®¬àòè- Ï®±òò°àí±ï«àíòàöè®ííàÿ Ðåàêöèÿ ®òò®°¦åíèÿ ò°àí±ï«àíòàòà,
°åàêöèÿ «ò°àí±ï«àíòàò ï°®òèâ µ®§ÿèíà»,
·å±ê®© ÀÃ, íà 4 ã°óïï»:
±òåí®§ à°òå°èè ïå°å±à¦åíí®© ï®·êè,
” ®±ò°»å §à᮫åâàíèÿ ï®·åê, ê®ò®°»å ¬®ãóò ®±«®¦íåíèÿ 謬óí®±óï°å±±èâí®© òå°àïèè
á»òü ®á°àò謻¬è (®±ò°»© ã«®¬å°ó«®íåô°èò, ®±ò- â ï®±«å®ïå°àöè®íí»© ïå°è®¤
°àÿ ï®·å·íàÿ í央±òàò®·í®±òü â ±òà¤èè ®«èãó°èè,
âà±êó«èò», è±µ®¤» ýê±ò°àê®°ï®°à«üí®© ó¤à°í®â®«- ÿ¬è ï°®íèöà嬮±òè ê«óá®·ê®â®© ¬å¬á°àí», 觬å-
í®â®© «èò®ò°èï±èè); íåíèÿ¬è ã嬮¤èíà¬èêè, àêòèâàöèå© ã󬮰à«üí»µ
” §à᮫åâàíèÿ ®¤í®© è«è ®áåèµ ï®·åê áå§ ï®- ±è±òå¬, ê®ò®°»å ⮧íèêàþò â ®òâåò íà 謬óíí»©,
·å·í®© í央±òàò®·í®±òè, â ·à±òí®±òè ﮫèêè±ò®§; â®±ïà«èòå«üí»© ï°®öå±±, ï°è⮤ÿùè© ê ãèáå«è
” µ°®íè·å±êèå §à᮫åâàíèÿ ï®·åê ± ï®·å·í®© íåô°®í®â, ó¬åíüøåíèþ ¬à±±» ï®·åê, ±íè¦åíèþ
í央±òàò®·í®±òüþ (¤èàáåòè·å±êàÿ íåô°®ïàòèÿ, ÿò- ã«®¬å°ó«ÿ°í®© ôè«üò°àöèè (±µå¬à). ‚ ï®±«å¤íèå
°®ãåíí»å íåô°®ïàòèè); 㮤» âà¦í®å §íà·åíèå ï°è¤àåò±ÿ ã嬮¤èíà¬è·å±-
” ãèïå°òåí§èÿ ï®±«å íåô°ýêò®¬èè (anephric êè¬ ¬åµàí觬ଠﰮã°å±±è°®âàíèÿ §à᮫åâàíèÿ
state) è ò°àí±ï«àíòàöèè ï®·êè [10]. ï®·åê, ±°å¤è ê®ò®°»µ ⻤å«ÿþò òàꮩ ꮬï®íåíò,
Ïàò®ãåíå§ °à§âèòèÿ Àà ï°è ïà°åíµè¬àò®§í»µ êàê âíóò°èê«óá®·ê®âàÿ ãèïå°òåí§èÿ. Ýò® ï®íÿòèå
§à᮫åâàíèÿµ ï®·åê ±«®¦åí, ®á󱫮â«åí íà°óøåíè- ừ® ââå¤åí® â 1982 ã. ï®±«å ®ïóá«èê®âàíèÿ °àá®ò
66 UKRAINIAN THERAPEUTIC JOURNAL
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‘µå¬à. Ïàò®ãåíå§ Àà ï°è ïà°åíµè¬àò®§í»µ §à᮫åâàíèÿµ ï®·åê



ã°óïï» à¬å°èêàí±êèµ è±±«å¤®âàòå«å© â® ã«àâå ± àíãè®òåí§èí®â®© ±è±ò嬻, âê«þ·àÿ ï®â»øåíèå ±è-
Á.Ì. Á°åííå°®¬ («ãèï®òå§à Á°åííå°à») [11]. ±òå¬í®ã® è âíóò°èê«óá®·ê®â®ã® ¤àâ«åíèÿ, óâå«è·å-
‚ ýê±ïå°è¬åíòå íà ê°»±àµ, ó ê®ò®°»µ ó¤à«åíà íèå °åàá±®°áöèè íàò°èÿ, ±®§¤àíèå 󱫮âè© ¤«ÿ ï°®-
®¤íà ï®·êà ï®«í®±òüþ è 2/3 ¤°ó㮩, àâò®°» ó±òà- òåèíó°èè, ê®ò®°»å ÿâ«ÿþò±ÿ ôàêò®°à¬è °à§âèòèÿ
í®âè«è, ·ò® â ýòèµ ó±«®âèÿµ ﰮ豵®¤èò à¤àïòèâ- ï®·å·í®© í央±òàò®·í®±òè [27]. Ë®êà«üíàÿ àêòèâà-
í»© ®òâåò ®±òàâøèµ±ÿ íåô°®í®â, §àê«þ·àþù話ÿ öèÿ °åíèí-àíãè®òåí§èí®â®© ±è±ò嬻 ®ï°å¤å«ÿåò
â ï®â»øåíèè ¤àâ«åíèÿ âíóò°è êত®ã® ê«óá®·êà ± òÿ¦å±òü ï®â°å¦¤åíèÿ ï®·åê. ‚ µ®¤å ýê±ïå°è¬åíòà«ü-
ï®±«å¤óþùå© ãèïå°ôè«üò°àöèå©, ·ò® ±®§¤àåò 󱫮- í»µ è±±«å¤®âàíè© ó±òàí®â«åí®, ·ò® öåíò°à«üí»¬
âèÿ ¤«ÿ í®°¬à«üí®© ±ê®°®±òè ê«óá®·ê®â®© ôè«üò- ¬åµàí觬®¬ ï°®ã°å±±è°®âàíèÿ §à᮫åâàíèÿ ï®·åê
°àöèè è áà«àí±à íàò°èÿ. Ê®¬ïåí±àò®°í»© µà°àê- ÿâ«ÿåò±ÿ ®ï®±°å¤®âàííàÿ àíãè®òåí§èí®¬ II â৮ê®í-
òå° °åàêöèè ï°®¤®«¦àåò±ÿ ê®°®òê®å â°å¬ÿ, òàê êàê ±ò°èêöèÿ ýôôå°åíòí®© à°òå°è®«», ï°è⮤ÿùàÿ ê
«®êà«üíàÿ ãèïå°òåí§èÿ ï®â°å¦¤àåò ±ò°óêòó°» ê«ó- ã«®¬å°ó«ÿ°í®© êàïè««ÿ°í®© ãèïå°òåí§èè.
á®·êà, ¬å§àíãèÿ, áà§à«üí®© ¬å¬á°àí», ®á󱫮â«è- ‘óùå±òâóþò ¤°óãèå ¬åµàí觬», ê®ò®°»å ®áúÿ±-
âàÿ ï®â»øåíèå èµ ï°®íèöà嬮±òè è êàê ±«å¤- íÿþò ï®â°å¦¤àþùåå ¤å©±òâèå àíãè®òåí§èíà II íà
±òâèå ” ï°®òåèíó°èè [21]. —å¬ â»øå ±òåïåíü ê«ó- ï®·êó.
á®·ê®â®© ãèïå°òåí§èè, òå¬ á»±ò°åå ï°®ã°å±±è°óþò Ï®â»øåíí»© ¬å§àíãèà«üí»© ï°èò®ê ¬àê°®¬®-
ï®·å·íàÿ í央±òàò®·í®±òü. «åêó« â ®òâåò íà èí¤óöè°®âàíí®å àíãè®òåí§èí®¬ II
Ï°è µ°®íè·å±ê®¬ §à᮫åâàíèè ï®·åê âå¤óùè¬ ï®â»øåíèå ã«®¬å°ó«ÿ°í®ã® ¤àâ«åíèÿ ±ï®±®á±òâó-
¬åµàí觬®¬ ÿâ«ÿåò±ÿ àêòèâàöèÿ °åíèí-àíãè®òåí§è- åò àêòèâàöèè öèò®êèí®â è ±òè¬ó«è°óåò ýê±ïàí±èþ
í®â®© ±è±ò嬻. Ê°®¬å ó·à±òèÿ â °åãó«ÿöèè ±è±òå¬- ¬å§àíãèà«üí®ã® ¬àò°èê±à [29]. Îí òàê¦å âå¤åò ê °à§-
í®© öè°êó«ÿöèè ꮬï®íåíò» °åíèí-àíãè®òåí§èí®- âèòèþ ã«®¬å°ó«®±ê«å°®§à íåã嬮¤èíà¬è·å±êè¬
⮩ ±è±ò嬻 ï°è±óò±òâóþò ⠰৫è·í»µ òêàíÿµ, ã«àâ- ïóòå¬, ±òè¬ó«è°óÿ ï°®¤óêöèþ íå±ê®«üêèµ ï®òåí-
í»¬ ®á°à§®¬ â ï®·êàµ, ï°åè¬óùå±òâåíí® â ê«åòêൠöèà«üí® ±ê«å°®§è°óþùèµ ¬å¤èàò®°®â, âê«þ·àÿ
¬å§àíãèÿ [16]. Ȥåíòèôèöè°®âàí® ±â»øå 200 ôóíê- ýí¤®òå«èí, ò°àí±ô®°¬è°óþùè© °®±ò ôàêò®° áåòà
öè© ï®·å·í®ã® àíãè®òåí§èíà II, ê®ò®°»å ó·à±òâóþò (TGF-β) è ò°®¬á®öèòà°í»© ôàêò®° °®±òà (PGF),
â ®áå±ïå·åíèè áà«àí±à ⮤» è íàò°èÿ [8]. Ï°è ï®- ⻧»âàÿ ãèïå°ò°®ôèþ è ãèïå°ï«à§èþ ï®·å·í»µ
·å·í®© ïàò®«®ãèè àêòèâè°óþò±ÿ °à§«è·í»å ã嬮¤è- ±ò°óêòó° [17]. ‚«èÿÿ íà ï®·å·í»å êàíà«üö», àíãè®-
íà¬è·å±êèå è íåã嬮¤èíà¬è·å±êèå ýôôåêò» °åíèí- òåí§èí II óâå«è·èâàåò ¬èò®ãåíí»© ýôôåêò ýïè¤å°-
67
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«àãåíà I è IV òèïà. ’àêè¬ ®á°à§®¬, ã嬮¤èíà¬è·å±- ò®°í»å ¬åò®¤» âê«þ·àþò ®ï°å¤å«åíèå àêòèâí®±òè
êèå, ã󬮰à«üí»å è ôàêò®°» °®±òà ±ï®±®á±òâóþò °åíèíà â âåí®§í®© ïå°èôå°è·å±ê®© ê°®âè, ï°è
°à§âèòèþ ã«®¬å°ó«®±ê«å°®§à, óµó¤øåíèþ ôóíêöèè ýò®¬ ᮫åå èíô®°¬àòèâí»¬ ÿâ«ÿåò±ÿ ®ï°å¤å«åíèå
ï®·åê, §à¤å°¦êå íàò°èÿ, ï®â»øåíèþ ïå°èôå°è·å±- ó°®âíÿ °åíèíà â âåí®§í®© ê°®âè, â§ÿò®© °à§¤å«üí®
ê®ã® ±®±ó¤è±ò®ã® ±®ï°®òèâ«åíèÿ, ô®°¬è°®âàíèþ è§ ï°à⮩ è «å⮩ ï®·å·í»µ âåí ï°è èµ êàòåòå°è§à-
Àà ± â»±®êè¬ ó°®âíå¬ À„ [5, 18, 24, 25]. öèè. ‚»±®ê®© ·óâ±òâèòå«üí®±òüþ ®ò«è·àåò±ÿ ôà°-
Ê«èíè·å±êè¬ ï°è§íàꮬ ±è¬ïò®¬àòè·å±ê®© Àà ¬àꮫ®ãè·å±êàÿ ï°®áà ± êàïò®ï°è«®¬ è«è ¤°óãè¬è
ó ᮫üí»µ ã«®¬å°ó«®íåô°èò®¬ è ïèå«®íåô°èò®¬ èíãèáèò®°à¬è àíãè®òåí§èíï°åâ°àùàþùåã® ôå°-
ÿâ«ÿþò±ÿ: ¬®«®¤®© ⮧°à±ò, °åô°àêòå°íàÿ è §«®êà- ¬åíòà (ÈÀÏ”), ê®ò®°àÿ ﰮ⮤èò±ÿ â ¤âóµ ¬®¤è-
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68 UKRAINIAN THERAPEUTIC JOURNAL
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íå®áµ®¤è¬® ±íè§èòü è«è óâå«è·èòü èíòå°âà« ¬å¦- òàê¦å óãíåòåíèÿ ±èíòå§à è â»±â®á®¦¤åíèÿ à«ü¤®-
¤ó ï°èå¬à¬è, ﰮ⮤èòü òùàòå«üí®å íàá«þ¤åíèå §à ±òå°®íà [14].
᮫üí»¬è, ê®íò°®«è°®âàòü ó°®âåíü ê°åàòèíèíà. Ï°åïà°àò» ýò®© ã°óïï» ®ê৻âàþò àíòèï°®òå-
…±«è ®í íå¬í®ã® ï®â»øàåò±ÿ è â òå·åíèå ï®±«å¤ó- èíó°è·å±ê®å è °åí®ï°®òåêò®°í®å ¤å©±òâèå ó ᮫ü-
þùåã® ¬å±ÿöà åã® íà°à±òàíèÿ íå ﰮ豵®¤èò, ¤®§ó í»µ ± ¤èàáåòè·å±ê®© è íå¤èàáåòè·å±ê®© íåô°®ïà-
¬®¦í® ®±òàâèòü áå§ è§¬åíåíè©. Ê®ã¤à ê®íöåíò°à- òèå© á«à㮤à°ÿ è§áè°àòå«üí®¬ó ±íè¦åíèþ ò®íó±à
öèÿ ê°åàòèíèíà â ê°®âè â»øå 3,5“4 ¬ã/¤«, è¬ååò ýôôå°åíòí»µ à°òå°è®«, âíóò°èê«óá®·ê®â®ã® ¤àâ-
òåí¤åíöèþ ê ï®â»øåíèþ, ï°åïà°àò ®ò¬åíÿþò. Êàê «åíèÿ [2, 28). Ï°è ±®ï®±òàâ«åíèè °åí®ï°®òåêò®°-
ï°àâè«®, ýò® á»âàåò ó ᮫üí»µ ± â»°à¦åíí®© ï®- í®ã® ýôôåêòà àíòàã®íè±ò®â °åöåïò®°®â àíãè®òåí-
·å·í®© í央±òàò®·í®±òüþ. ’°åáóåò±ÿ ó¤å«ÿòü âíè- §èíà II è àíòàã®íè±ò®â êà«üöèÿ ï°®«®íãè°®âàíí®-
¬àíèå ᮫üí»¬ ± áè«àòå°à«üí»¬ ±òåí®§®¬ à°òå°è© ã® ¤å©±òâèÿ â è±±«å¤®âàíèè IDNT (Irbersartan
ï®·åê è«è ±òåí®§®¬ à°òå°è© å¤èí±òâåíí®© ï®·êè. Diabetic Nephropathy Trial) ừ® ó±òàí®â«åí®, ·ò®
ÈÀÏ”, ï°è¬åíÿ嬻å â ±®·åòàíèè ± íå±òå°®è¤í»- è°áå°±à°òàí â ᮫üøå© ±òåïåíè ±íè¦à« ±óò®·íóþ
¬è ï°®òèâ®â®±ïà«èòå«üí»¬è ±°å¤±òâà¬è, òå®°åòè- ï°®òåèíó°èþ, ï®â»øà« ê«è°åí± ê°åàòèíèíà, ·å¬
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70 UKRAINIAN THERAPEUTIC JOURNAL
Ë…Ê–²¯
ÊËÀ‘È”²ÊÀ–²ß, ÏÀ’ÎÃ…Í…Ç ² CLASSIFICATION, PATHOGENESIS AND
˲ʓ‚ÀÍÍß Í…”ÐÎÃ…ÍÍί TREATMENT OF NEPHOGENIC ARTERIAL
ÀÐ’…вÀËÜÍί òυВ…ÍDz¯ HYPERTENSION
Î.Ì. Ê®âà«ü®âà O.N. Kovalyova
Ðå§þ¬å. “§àãà«üíåíi ﮫ®¦åííÿ ï°® ê«à±èôiêàöiþ, Summary. The review summarizes the modern advances
¬åµàíi§¬è °®§âèòêó òà òàêòèêó ê®°åêö³¿ íåô°®ãåí- about classification, the mechanisms of development and
í®¿ à°òå°³à«üí®¿ ã³ïå°òåí§³¿ (ÀÃ). Ю§ã«ÿíóòà °®«ü treatment of nephrogenic arterial hypertension. The role
ã嬮¤èíଳ·íèµ òà íåã嬮¤èíଳ·íèµ ôàêò®°iâ â of hemodynamic and nonhemodynamic factors in the
ïàò®ãåíå§i ïi¤âèùåííÿ à°òå°ià«üí®ã® òè±êó ó ïà- pathogenesis of elevated blood pressure at patients with
ö³ºíò³â § ïà°åíµi¬àò®§íè¬è §àµâ®°þâàííÿ¬è íè°®ê. renoparenchymatous disease is lighted out. Special at-
α®á«èâó óâàãó ï°è¤i«åí® ê®¬ï®íåíòଠ°åíií- tention is paid to the components of renin-angiotensin
àíãi®òåí§èí®â®¿ ±è±òå¬è, ÿê³ áå°óòü ó·à±òü ó ï°®- system involved to the mesangial proliferation, vasocon-
«³ôå°àö³¿ ¬å§àíã³þ, â৮ê®í±ò°èêö³¿, ã«®¬å°ó«ÿ°í®¿ striction, glomerular hypertension, progression of renal
êàïi«ÿ°í®¿ ã³ïå°òåí§³¿, ï°®ã°å±óâàííi íè°ê®â®¿ impairment. The theoretical base and clinical indication
í央±òàòí®±òi. ϰ失òàâ«åíi òå®°åòè·íi ïå°å¤- for treatment of hypertension using the ACE inhibitors,
ó¬®âè òà ê«iíi·íi ï®êà§àííÿ ¤«ÿ «iêóâàííÿ Àà ó µâ®- Angiotensin II Receptor Antagonists, calcium channel
°èµ íåô°®«®ã³·í®ã® ï°®ô³«þ § âèê®°è±òàííÿ¬ ií- blocked are considered. Understanding of influence these
ãiáiò®°iâ àíã³®òåí§èíïå°åòâ®°þâà«üí®ã® ôå°¬åíòó drugs at the systemic and intraglomerular hypertension,
(ÀÏ”), àíòàã®íi±òiâ °åöåïò®°iâ àíãi®òåí§èíó II, natriuresis, aldosteron production relevant to the patho-
àíòàã®íi±òiâ êà«üöiþ. „àí® ïàò®ãåíåòè·íå ®áã°óí- genesis is shown. In addition to the antihypertensive effi-
òóâàííÿ âï«èâó öèµ ï°åïà°àòiâ íà ±è±òå¬íó òà cacy have been recently established the antiproteinuric
âíóò°³øíü®ê«óá®·ê®âó ãiïå°òåí§iþ, íàò°³©ó°å§, ±èí- and renoprotective benefits of ACE i and AIIRA repre-
òå§ à«ü¤®±òå°®íó. Ï®°ÿ¤ § ⳤ®¬è¬è àíòèã³ïå°òåí- sented a promising new therapeutic approach in nephro-
§èâíè¬è â«à±òèâ®±òÿ¬è âè±âiò«åíi íåù®¤àâí® âèÿâ- logy.
«åí³ àíòèï°®òå¿íó°è·í³ òà °åí®ï°®òåêò®°í³ åôåê-
Key words: renoparenchymal hypertension, renin-
òè iíãiáiò®°iâ ÀÏ”, àíòàã®íi±òiâ °åöåïò®°iâ
angiotensin system, ACE inhibitors, Angiotensin II
àíãi®òåí§èíó II, ù® §íà·í® °®§øè°þº ꮫ® òå°àïåâ-
Receptor Antagonists, calcium channel blockers.
òè·í®ã® §à±ò®±óâàííÿ öèµ «iêà°±üêèµ §à±®áiâ â íå-
ô°®«®ã³¿.
À¤°å± ¤«ÿ ïå°åïè±êè:
Ê«þ·®âi ±«®âà: °åí®ïà°åíµ³¬àò®§íà à°òå°ià«üíà
ãiïå°òåí§iÿ, °åíií-àíãi®òåí§èí®âà ±è±òå¬à, ií- Ê®âà«åâà Ϋüãà Íèꮫàåâíà
ãiáiò®°è àíã³®òåí§èíïå°åòâ®°þâà«üí®ã® ôå°- 61022, •à°üê®â, ï°®±ï. Ëåíèíà, 4
¬åíòó, àíòàã®íi±òè °åöåïò®°iâ àíãi®òåí§èíó II, •à°üê®â±êè© ã®±ó¤à°±òâåíí»© ¬å¤èöèí±êè©
óíèâå°±èòåò, êàô夰à ï°®ïå¤åâòèêè ¹ 1
àíòàã®íi±òè êà«üöiþ.




71
“ÊÐÀ¯Í‘ÜÊÈÉ ’…ÐÀÏ…‚’È—ÍÈÉ Æ“ÐÍÀË