Stroke:强化血压治疗可降低白蛋白尿患者的卒中风险

2019-10-22 xing.T MedSci原创

由此可见,在对SPRINT进行事后分析中,基线蛋白尿(相对于无蛋白尿)与发生卒中的风险较高相关,但这种关系似乎仅限于标准治疗组。需要进一步的研究来最终确定降低蛋白尿本身是否有利于降低卒中风险。

蛋白尿与糖尿病患者的卒中风险有关。但是,非糖尿病患者蛋白尿与卒中之间的相关性尚不清楚。近日,心血管疾病领域权威杂志Stroke上发表了一篇研究文章,研究人员对收缩压干预试验(SPRINT)进行了事后分析,在8913名没有糖尿病的参与者中探究了高强度血压管理和低强度血​​压管理对死亡率的影响。

研究人员采用未经调整和调整后的Cox比例风险模型来估计基线白蛋白尿(尿白蛋白与肌酐比值≥30mg/g vs. <30mg/g)与卒中风险之间的关联。研究人员还根据治疗组评估了效果改善情况。

参与者平均年龄为68±9岁,女性为35%,黑人占30%。中位随访时间为3.2年,有19%的患者基线时存在蛋白尿。随访期间发生卒中的人数为129人。蛋白尿与卒中风险增加相关(未调整的风险比为2.24;95%CI为1.55-3.23;经调整的风险比为1.73;95%CI为1.17-2.56)。蛋白尿与卒中的相关性随者随机治疗组的不同而有所差异(交互作用P=0.03)。在强化治疗组中,蛋白尿和卒中的相关性不显著(未调整的风险比为1.25;95%CI为0.69–2.28),而在标准治疗组中,这种相关性显著(未调整的风险比为3.44;95%CI为2.11–5.61)。

由此可见,在对SPRINT进行事后分析中,基线蛋白尿(相对于无蛋白尿)与发生卒中的风险较高相关,但这种关系似乎仅限于标准治疗组。需要进一步的研究来最终确定降低蛋白尿本身是否有利于降低卒中风险。 

原始出处:

Lia Leitão.et al.Intensive Blood Pressure Treatment Reduced Stroke Risk in Patients With Albuminuria in the SPRINT Trial.stroke.2019.https://www.ahajournals.org/doi/10.1161/STROKEAHA.119.026316

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    2019-11-19 147652cbm37暂无昵称

    分析到位。

    0

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    2019-10-24 珙桐
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    2019-10-22 健健

    卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=375530, encodeId=3da33e553060, content=分析到位。, beContent=null, objectType=article, channel=null, level=null, likeNumber=67, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d9095213479, createdName=147652cbm37暂无昵称, createdTime=Tue Nov 19 11:44:58 CST 2019, time=2019-11-19, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1281325, encodeId=50ed12813250c, content=<a href='/topic/show?id=455f36085f0' target=_blank style='color:#2F92EE;'>#卒中风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=36085, encryptionId=455f36085f0, topicName=卒中风险)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=a8f1167, createdName=wmr111, createdTime=Thu Oct 24 09:55:00 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1304664, encodeId=a22b13046647c, content=<a href='/topic/show?id=cd37e1767b5' target=_blank style='color:#2F92EE;'>#白蛋白#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71767, encryptionId=cd37e1767b5, topicName=白蛋白)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=25d7319, createdName=珙桐, createdTime=Thu Oct 24 09:55:00 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1377108, encodeId=ec0213e710802, content=<a href='/topic/show?id=ae99e1769f9' target=_blank style='color:#2F92EE;'>#白蛋白尿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=54, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=71769, encryptionId=ae99e1769f9, topicName=白蛋白尿)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7dc7399, createdName=apoenzyme, createdTime=Thu Oct 24 09:55:00 CST 2019, time=2019-10-24, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1026480, encodeId=2c1d10264801d, content=卒中虽然是临床上常见病,溶栓,取栓等血管内治疗也很成熟,但是仍然有很多未知问题有待认知!, beContent=null, objectType=article, channel=null, level=null, likeNumber=53, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=健健, createdTime=Tue Oct 22 21:55:00 CST 2019, time=2019-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1045904, encodeId=c51b104590487, content=中风是俗称,应该称为缺血性卒中吧, beContent=null, objectType=article, channel=null, level=null, likeNumber=34, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=guging, createdTime=Tue Oct 22 21:55:00 CST 2019, time=2019-10-22, status=1, ipAttribution=)]
    2019-10-22 guging

    中风是俗称,应该称为缺血性卒中吧

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