J Hypertens:叶酸治疗降低大量蛋白尿的高血压患者死亡风险!

2017-05-21 xing.T MedSci原创

由此可见,在没有主要心血管疾病史的高血压患者中,叶酸治疗可以降低重度蛋白尿患者相关的死亡风险。

近日,高血压领域权威杂志Journal of Hypertension上发表了一篇研究文章,研究人员旨在评估蛋白尿和肾小球滤过率(eGFR)水平是否能改变叶酸治疗对参加中国脑卒中一级预防试验的高血压患者全因死亡率的效应,该研究是一项随机、双盲的对照试验。

该研究共纳入了20702名无主要心血管疾病史的高血压患者,并将其随机分组,每日接受单一片剂含10毫克依那普利和0.8毫克叶酸(n=10348)或单纯的10毫克依那普利(n=10354)进行双盲治疗。以中国脑卒中一级预防试验预先设定的终点-全因死亡率作为本研究分析的主要结局。

在平均4.5年的治疗期间,在单纯的依那普利治疗组,大量蛋白尿[vs. 无蛋白尿参与者,10.8 vs. 2.7%;风险比=3.30;95%可信区间(CI)为2.10-5.18]和较低的eGFR水平(<60 vs. ≥90 毫升/每分钟/1.73 平方米,13 vs. 2.2%;风险比=1.93;95%可信区间为1.19-3.12)均与全因死亡率风险增加显著相关。补充叶酸能显著降低重度蛋白尿患者的全因死亡率风险(在依那普利联合叶酸组为6.4% vs. 单纯依那普利组10.8%,风险比=0.49;95%可信区间为0.26-0.94),而不是在那些无或轻度蛋白尿参与者中(2.8 vs. 2.9%,风险比=0.99;95%可信区间为0.84-1.17;相互作用P=0.040)。然而,eGFR水平没有显著改变补充叶酸降低全因死亡率风险的效应(相互作用P=0.228)。

由此可见,在没有主要心血管疾病史的高血压患者中,叶酸治疗可以降低重度蛋白尿患者相关的死亡风险。

原始出处:

Li, Youbaoa.et al. Folic acid therapy reduces the risk of mortality associated with heavy proteinuria among hypertensive patients.Journal of Hypertension. 2017. http://journals.lww.com/jhypertension/Abstract/2017/06000/Folic_acid_therapy_reduces_the_risk_of_mortality.25.aspx

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    2017-06-12 feather89
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    2017-05-22 杨利洪

    学习了,提高自己

    0

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    2017-05-21 flysky120

    叶酸的作用。

    0

  8. [GetPortalCommentsPageByObjectIdResponse(id=1983510, encodeId=805d19835108a, content=<a href='/topic/show?id=628553048e3' target=_blank style='color:#2F92EE;'>#患者死亡#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=84, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53048, encryptionId=628553048e3, topicName=患者死亡)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=12de429, createdName=sunylz, createdTime=Fri Nov 10 04:43:00 CST 2017, time=2017-11-10, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1726424, encodeId=0d851e26424b6, content=<a href='/topic/show?id=986913980dd' target=_blank style='color:#2F92EE;'>#PE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=13980, encryptionId=986913980dd, topicName=PE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f06c33759375, createdName=feather89, createdTime=Mon Jun 12 09:43:00 CST 2017, time=2017-06-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2038656, encodeId=f2e6203865630, content=<a href='/topic/show?id=b45d1e274e8' target=_blank style='color:#2F92EE;'>#TENS#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=65, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=17274, encryptionId=b45d1e274e8, topicName=TENS)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=3b172500206, createdName=12498ebem19暂无昵称, createdTime=Wed Apr 25 13:43:00 CST 2018, time=2018-04-25, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1255638, encodeId=46d71255638e8, content=<a href='/topic/show?id=587f6339050' target=_blank style='color:#2F92EE;'>#死亡风险#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=78, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=63390, encryptionId=587f6339050, topicName=死亡风险)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=74808, createdName=quxin068, createdTime=Tue May 23 06:43:00 CST 2017, time=2017-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1448185, encodeId=29a9144818548, content=<a href='/topic/show?id=5a9c102681f2' target=_blank style='color:#2F92EE;'>#高血压患者#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=102681, encryptionId=5a9c102681f2, topicName=高血压患者)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=b4665409655, createdName=维他命, createdTime=Tue May 23 06:43:00 CST 2017, time=2017-05-23, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=201081, encodeId=876620108126, content=学习了,提高自己, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2017/09/21/39b6a0099eb602e8ac1f7e10d5d440a9.jpg, createdBy=dee01724555, createdName=杨利洪, createdTime=Mon May 22 07:12:10 CST 2017, time=2017-05-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200937, encodeId=ba0a20093e07, content=叶酸的作用。, beContent=null, objectType=article, channel=null, level=null, likeNumber=127, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://cacheapi.medsci.cn/resource/upload/20160718/IMG578C993D395567540.jpg, createdBy=59b81918946, createdName=flysky120, createdTime=Sun May 21 18:49:29 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200925, encodeId=5ee2200925d0, content=叶酸治疗可以降低重度蛋白尿患者相关的死亡风险,很好,我父亲正好符合上述情况,试试无妨。, beContent=null, objectType=article, channel=null, level=null, likeNumber=94, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/Q3auHgzwzM4o2XVpJ6449yqDsjibydI5HnJ8MibGxNn4HZiaZib0bdfibbwoz3KQrIyN9AGxq36ZlZRNicYlPfOOWMtwgsajY6mGNFiaPclFdowjD0/0, createdBy=97bd1338592, createdName=清风拂面, createdTime=Sun May 21 17:15:33 CST 2017, time=2017-05-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=200910, encodeId=479020091084, content=学习啦谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mONcle9pic3zSn0GqHrsfLK1wzJZRTON4gxYUibhUyOypBwMibC4R7SsppicGhz5Ogoy0VVq4CWnqaD2Moeib8RWxI5lOiaVmnxpan/0, createdBy=c53f1730331, createdName=tanxingdoctor, createdTime=Sun May 21 16:16:38 CST 2017, time=2017-05-21, status=1, ipAttribution=)]
    2017-05-21 清风拂面

    叶酸治疗可以降低重度蛋白尿患者相关的死亡风险,很好,我父亲正好符合上述情况,试试无妨。

    0

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    2017-05-21 tanxingdoctor

    学习啦谢谢分享

    0

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