查看“Irbesartan”的源代码

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            <strong>[[厄贝沙坦]]</strong>（<strong>[[Irbesartan]]</strong>）是一种强效、口服有效的长效<strong>[[血管紧张素II受体拮抗剂]]</strong>（[[ARB]]），属于非肽类联苯四唑衍生物。它通过高选择性地阻断<strong>[[血管紧张素II]]</strong>与<strong>[[AT1受体]]</strong>的结合，从而发挥降压及器官保护作用。临床上，[[厄贝沙坦]]不仅是治疗<strong>[[原发性高血压]]</strong>的一线药物，更因其在[[IDNT]]和[[IRMA-2]]等大型研究中展现出的卓越肾脏保护效能，成为合并<strong>[[2型糖尿病肾病]]</strong>患者的标准治疗方案。在2026年的精准医疗背景下，[[厄贝沙坦]]的应用已延伸至基于<strong>[[CYP2C9]]</strong>基因型分层的个体化剂量管理，以优化血管保护获益。
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            <div style="font-size: 1.2em; font-weight: bold; letter-spacing: 1.2px;">[[厄贝沙坦]]</div>
            <div style="font-size: 0.75em; opacity: 0.85; margin-top: 4px;">[[Irbesartan]] / [[安博维]] · 点击展开</div>
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                <div style="font-size: 0.8em; color: #64748b; margin-top: 12px; font-weight: 600;">核心靶点：[[AGTR1]] (185)</div>
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                    <td style="padding: 8px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">185([[AGTR1]])</td>
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                    <th style="text-align: left; padding: 8px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">[[HGNC]]ID</th>
                    <td style="padding: 8px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">336</td>
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                    <td style="padding: 8px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">P30556</td>
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                    <th style="text-align: left; padding: 8px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">药物类型</th>
                    <td style="padding: 8px 12px; border-bottom: 1px solid #e2e8f0; color: #1e40af;">[[ARB类降压药]]</td>
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                    <th style="text-align: left; padding: 8px 12px; background-color: #f1f5f9; color: #475569; border-bottom: 1px solid #e2e8f0;">分子式</th>
                    <td style="padding: 8px 12px; border-bottom: 1px solid #e2e8f0; color: #0f172a;">$C_{25}H_{28}N_{6}O$</td>
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                    <th style="text-align: left; padding: 8px 12px; background-color: #f1f5f9; color: #475569;">分子量</th>
                    <td style="padding: 12px; color: #0f172a;">428.5 Da</td>
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    <h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">药理机制：精准阻断AT1信号轴</h2>
    
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        [[厄贝沙坦]]通过对<strong>[[肾素-血管紧张素-醛固酮系统]]</strong>（[[RAAS]]）的末端拦截发挥作用，其分子逻辑如下：
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        <li style="margin-bottom: 12px;"><strong>竞争性受体拮抗：</strong>[[厄贝沙坦]]对[[AT1受体]]的亲和力是[[AT2受体]]的8000倍以上。通过与[[AT1受体]]结合，阻断[[血管紧张素II]]诱导的血管收缩、[[醛固酮]]释放及[[交感神经]]激活。</li>
        <li style="margin-bottom: 12px;"><strong>肾小球血流动力学调节：</strong>通过扩张[[肾小球]]出球小动脉，显著降低肾小球内静水压。这一机制是其缓解[[蛋白尿]]、延缓[[慢性肾功能不全]]进展的核心基础。</li>
        <li style="margin-bottom: 12px;"><strong>抗纤维化与抗炎：</strong>长期应用可抑制转化生长因子（[[TGF-β]]）介导的[[心肌重塑]]和肾间质纤维化，具有超越单纯降压之外的靶器官保护效应。</li>
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    <h2 style="background: #f1f5f9; color: #0f172a; padding: 10px 18px; border-radius: 0 6px 6px 0; font-size: 1.25em; margin-top: 40px; border-left: 6px solid #0f172a; font-weight: bold;">临床应用矩阵：降压与肾保护的双重基石</h2>

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                <th style="padding: 10px; border: 1px solid #cbd5e1; color: #0f172a; width: 25%;">适应症</th>
                <th style="padding: 10px; border: 1px solid #cbd5e1; color: #475569;">临床证据背景</th>
                <th style="padding: 10px; border: 1px solid #cbd5e1; color: #1e40af;">治疗获益</th>
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                <td style="padding: 8px; border: 1px solid #cbd5e1; font-weight: 600;">[[原发性高血压]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">24小时血压平滑监测</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">谷峰比（[[T/P ratio]]）高，每日给药一次即可稳定控制清晨高血压。</td>
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                <td style="padding: 8px; border: 1px solid #cbd5e1; font-weight: 600;">[[合并高血压的2型糖尿病肾病]]</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">[[IDNT]] 研究</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">相比[[氨氯地平]]或安慰剂，显著降低血肌酐翻倍风险及终末期肾病（[[ESRD]]）发生率。</td>
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                <td style="padding: 8px; border: 1px solid #cbd5e1; font-weight: 600;">[[微量白血病尿]]（2型糖尿病）</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">[[IRMA-2]] 研究</td>
                <td style="padding: 8px; border: 1px solid #cbd5e1;">剂量依赖性地延缓甚至逆转微量白蛋白尿向大量蛋白尿的转化。</td>
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        [[厄贝沙坦]]的规范应用需结合患者的生化指标及遗传背景进行动态调整：
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        <li style="margin-bottom: 12px;"><strong>精准剂量分层：</strong>[[厄贝沙坦]]主要由<strong>[[CYP2C9]]</strong>酶代谢。对于携带 *3 弱代谢等位基因的个体，血药浓度可能显著升高，需严密监测其心血管及肾功能指标。</li>
        <li style="margin-bottom: 12px;"><strong>双通道排泄优势：</strong>[[厄贝沙坦]]经胆汁和肾脏双途径排泄（各占约80%和20%），对于轻中度肝、肾功能不全者通常无需调整剂量，安全性窗口宽。</li>
        <li style="margin-bottom: 12px;"><strong>“黄金搭档”联合：</strong>2026年指南推荐将[[厄贝沙坦]]与低剂量[[利尿剂]]（如[[氢氯噻嗪]]）或新一代[[SGLT2抑制剂]]联用，以实现协同降压及最大化的心肾保护。</li>
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            <li style="margin-bottom: 8px;"><strong>[[AGTR1]]：</strong>编码 [[AT1受体]] 的基因，是厄贝沙坦发挥降压效应的关键分子靶标。</li>
            <li style="margin-bottom: 8px;"><strong>[[CYP2C9]]：</strong>决定厄贝沙坦体内清除速率的核心代谢酶。</li>
            <li style="margin-bottom: 8px;"><strong>[[糖尿病肾病]] (DN)：</strong>厄贝沙坦最具证据支持的靶器官保护适应症。</li>
            <li style="margin-bottom: 8px;"><strong>[[缬沙坦]]：</strong>同类 [[ARB]] 药物，常在临床路径中作为厄贝沙坦的对标参考。</li>
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        <span style="color: #0f172a; font-weight: bold; font-size: 1.05em; display: inline-block; margin-bottom: 15px;">学术参考文献与权威点评</span>
        
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            [1] <strong>Lewis EJ, et al. (2001).</strong> <em>Renoprotective effect of the angiotensin-II-receptor antagonist irbesartan in patients with nephropathy due to type 2 diabetes (IDNT).</em> <strong>[[The New England Journal of Medicine]]</strong>. 345(12):851-60.[Academic Review]<br>
            <span style="color: #475569;">[权威点评]：该研究奠定了 ARB 类药物在糖尿病肾病治疗中的金标准地位。</span>
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            [2] <strong>Parving HH, et al. (2001).</strong> <em>The effect of irbesartan on the development of diabetic nephropathy in patients with type 2 diabetes (IRMA-2).</em> <strong>[[NEJM]]</strong>. 345:870-8.<br>
            <span style="color: #475569;">[核心价值]：明确了高剂量厄贝沙坦在预防糖尿病肾病早期进展中的独立获益。</span>
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            [[厄贝沙坦]] (Irbesartan) 诊疗生态 · 知识图谱
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">关联因子</td>
                <td style="padding: 10px 15px; color: #334155;">[[AGTR1]]•[[RAAS]]•[[CYP2C9]]•[[Angiotensin II]]•[[Aldosterone]]</td>
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">同类/迭代</td>
                <td style="padding: 10px 15px; color: #334155;">[[替米沙坦]]•[[缬沙坦]]•[[氯沙坦]]•[[奥美沙坦]]•[[阿利沙坦酯]]</td>
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">战略实体</td>
                <td style="padding: 10px 15px; color: #334155;">[[Sanofi]] (赛诺菲)•[[FDA]]•[[WHO]]•[[BMS]]</td>
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                <td style="width: 85px; background-color: #f8fafc; color: #334155; font-weight: 600; padding: 10px 12px; text-align: right; vertical-align: middle; white-space: nowrap;">前沿研究</td>
                <td style="padding: 10px 15px; color: #334155;">[[ARB联合ARNI治疗心衰探索]]•[[针对CYP2C9弱代谢者的剂量模型]]•[[厄贝沙坦在抗衰老及预防阿尔茨海默病中的队列研究]]</td>
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