• 四川大學(xué)華西醫(yī)院金卡醫(yī)院,成都610041;

目的 　檢索應(yīng)用血管緊張素轉(zhuǎn)換酶抑制劑防治2型糖尿病患者蛋白尿的臨床證據(jù),以指導(dǎo)臨床實踐.
方法 　計算機檢索MEDLINE(1970～2005.6)關(guān)于血管緊張素轉(zhuǎn)換酶抑制劑對2型糖尿病患者蛋白尿防治效果的隨機對照試驗.
結(jié)果 　檢索到1篇隨機對照試驗,納入1 204例患者.結(jié)果顯示,血管緊張素轉(zhuǎn)換酶抑制劑可阻止2型糖尿病患者發(fā)生蛋白尿,效果明顯優(yōu)于其他藥物,但此類藥物也是引起心血管不良反應(yīng)甚至死亡的主要危險因素.應(yīng)用此證據(jù)為患者釋疑,患者表示滿意.
結(jié)論 　血管緊張素轉(zhuǎn)換酶抑制劑可以阻止高血壓及2型糖尿病患者的腎功能損害.

引用本文： 李治鵬,李雙慶. 1例2型糖尿病患者蛋白尿的循證防治. 中國循證醫(yī)學(xué)雜志, 2005, 05(8): 644-645. doi: 復(fù)制

1. Ruggenenti P, Fassi A, Ilieva AP, Bruno S, Iliev IP, Brusegan V, Rubis N, Gherardi G, Arnoldi F, Ganeva M, Ene-Iordache B, Gaspari F, Perna A, Bossi A, Trevisan R, Dodesini AR, Remuzzi G; Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) Investigators. Preventing microalbuminuria in type 2 diabetes[J]. N Engl J Med, 2004; 351(19): 1941-1951.
2. Ravid M, Brosh D, Levi Z, Bar-Dayan Y, Ravid D, Rachmani R. Use of enalapril to attenuate decline in renal function in normotensive, normoalbuminuric patients with type 2 diabetes mellitus. A randomized, controlled trial[J]. Ann Intern Med, 1998; 128(12 Pt 1): 982-988.
3. Murayama S, Hirano T, Sakaue T, Okada K, Ikejiri R, Adachi M. Low-dose candesartan cilexetil prevents early kidney damage in type 2 diabetic patients with mildly elevated blood pressure[J]. Hypertens Res, 2003; 26(6): 453-458.
4. Strojek K, Grzeszczak W, Gorska J, Leschinger MI, Ritz E. Lowering of microalbuminuria in diabetic patients by a sympathicoplegic agent: novel approach to prevent progression of diabetic nephropathy[J] ? J Am Soc Nephrol, 2001; 12(3): 602-605.
5. O’Hare P, Bilbous R, Mitchell T, O’Callaghan CJ, Viberti GC; Ace-Inhibitor Trial to Lower Albuminuria in Normotensive Insulin-Dependent Subjects Study Group. Low-dose ramipril reduces microalbuminuria in type 1 diabetic patients without hypertension: results of a randomized controlled trial[J]. Diabetes Care, 2000; 23(12): 1823-1829.
6. Shichiri M, Kishikawa H, Ohkubo Y, Wake N. Long-term results of the Kumamoto Study on optimal diabetes control in type 2 diabetic patients[J]. Diabetes Care, 2000; 23(Suppl 2): B21-29.
7. Arcaro G, Zenere BM, Saggiani F, et al. ACE inhibitors improve endothelial function in type 1 diabetic patients with normal arterial pressure and microalbuminuria[J]. Diabetes Care, 1999; 22(9): 1536-1542.
  1. 1. Ruggenenti P, Fassi A, Ilieva AP, Bruno S, Iliev IP, Brusegan V, Rubis N, Gherardi G, Arnoldi F, Ganeva M, Ene-Iordache B, Gaspari F, Perna A, Bossi A, Trevisan R, Dodesini AR, Remuzzi G; Bergamo Nephrologic Diabetes Complications Trial (BENEDICT) Investigators. Preventing microalbuminuria in type 2 diabetes[J]. N Engl J Med, 2004; 351(19): 1941-1951.
  2. 2. Ravid M, Brosh D, Levi Z, Bar-Dayan Y, Ravid D, Rachmani R. Use of enalapril to attenuate decline in renal function in normotensive, normoalbuminuric patients with type 2 diabetes mellitus. A randomized, controlled trial[J]. Ann Intern Med, 1998; 128(12 Pt 1): 982-988.
  3. 3. Murayama S, Hirano T, Sakaue T, Okada K, Ikejiri R, Adachi M. Low-dose candesartan cilexetil prevents early kidney damage in type 2 diabetic patients with mildly elevated blood pressure[J]. Hypertens Res, 2003; 26(6): 453-458.
  4. 4. Strojek K, Grzeszczak W, Gorska J, Leschinger MI, Ritz E. Lowering of microalbuminuria in diabetic patients by a sympathicoplegic agent: novel approach to prevent progression of diabetic nephropathy[J] ? J Am Soc Nephrol, 2001; 12(3): 602-605.
  5. 5. O’Hare P, Bilbous R, Mitchell T, O’Callaghan CJ, Viberti GC; Ace-Inhibitor Trial to Lower Albuminuria in Normotensive Insulin-Dependent Subjects Study Group. Low-dose ramipril reduces microalbuminuria in type 1 diabetic patients without hypertension: results of a randomized controlled trial[J]. Diabetes Care, 2000; 23(12): 1823-1829.
  6. 6. Shichiri M, Kishikawa H, Ohkubo Y, Wake N. Long-term results of the Kumamoto Study on optimal diabetes control in type 2 diabetic patients[J]. Diabetes Care, 2000; 23(Suppl 2): B21-29.
  7. 7. Arcaro G, Zenere BM, Saggiani F, et al. ACE inhibitors improve endothelial function in type 1 diabetic patients with normal arterial pressure and microalbuminuria[J]. Diabetes Care, 1999; 22(9): 1536-1542.