Nat Rev Cardiol:马长生和刘静盘点中国心血管病研究:2017年超3000篇论文发表在国际期刊,仅27篇在第一期刊

2019-08-15 卢芳 中国循环杂志

近日,Nature子刊发表了北京安贞医院马长生和刘静两位教授述评文章,称当前中国心血管研究虽有不足之处,但预计十年内,研究质量持续提高并将赶上发达国家。作者介绍,10年来,为了有效控制心血管病,中国在临床研究投入了大量资金。2018年,国家科学基金投入了2.59亿元人民币资助了594个心血管系统相关项目,是2004年投入的10倍。

血管领域研究质量10年内有望赶上发达国家

近日,Nature子刊发表了北京安贞医院马长生和刘静两位教授述评文章,称当前中国心血管研究虽有不足之处,但预计十年内,研究质量持续提高并将赶上发达国家。作者介绍,10年来,为了有效控制心血管病,中国在临床研究投入了大量资金。2018年,国家科学基金投入了2.59亿元人民币资助了594个心血管系统相关项目,是2004年投入的10倍。

2016年国家重点研发计划,投入超出了6亿人民币,资助了多于50项心血管病相关项目。除了政府投入外,企业投资也在一直增加,有超出1/4在美国临床试验数据库注册的心血管病研究由企业资助。有投入就有回报。截至2019年7月,中国大陆地区有15000项临床研究在美国临床试验数据库注册。

除了研究的量的大幅上升,一些多中心随机对照试验也“掷地有声”,颇有影响,比如BRIGHT试验,CSPPT试验和DKCRUSH-V试验等。此外,大型注册研究也已建立,比如CCC Project,China PEACE和China-AF注册研究等。这些注册均会在推动中国心血管病临床研究有所作为。随着科学研究的稳步增加,科学论文也水涨船高。2017年有多于36万篇论文发表在不同国际期刊上。中国科学论文的发表占整体的18.6%,仅次于美国。

临床研究“质”滞后于“量”:改善可从4方面着手

作者指出,临床研究的量上去了,但质尚有进一步提升空间。比如在2017年发表的约3000篇心血管病方面的论文,仅27篇刊登在《欧洲心脏杂志》、《循环》、《美国心脏病学会杂志》这些顶级期刊上。高质量、设计严谨的研究,意味着重要临床数据的产生,和临床实践的优化和革新,这在当前迫切需要。此外,将有价值的研究结果转化到心血管病防治实践中也尚需走一段长路。作者指出,临床研究当前存在的短板有待从以下四方面着手去提升:

临床研究要注重质量,尤其是多中心、随机对照研究和注册研究;

与政府相关部门协作以提高医院出院数据和医保数据的可用性;

提高科研能力,加强交流合作,以促进多方合作以及提高研究质量;

加强学术交流,注重在学术会议和高质量期刊传播研究结果。

其中值得注意的是,虽然中国心血管病患者人数多临床数据庞大,但不便于研究者使用。很多研究规模小且仍靠人工收集数据。而地球另一端的欧美,行政数据和医保数据已成为真实世界临床研究的资源。不过,中国政府已着手加强卫生信息系统管理,尤其是医院出院数据库和医保数据库。此外,从学术组织到心脏病学家都比较关注临床研究的发展。除了一些患者登记的建立,比如中华心血管病学会建立的中国心血管病登记(CVDR)外,一些高质量的旨在改善介入治疗的随机对照试验也在增加。心血管病科学研究的日益发展,必将为国人心血管健康带来极大的改善。

原始出处:
Liu J, Ma C. Current state of cardiovascular research in China. Nat Rev Cardiol. 2019 Aug 9.

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    2020-02-26 liye789132251
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