BMJ：ACEI为糖尿病患者**降压药

2013-10-30 蔡晓峰医学界网站

我国台湾学者简国龙、杜裕康等新近发表的一项荟萃分析显示，血管紧张素转换酶抑制剂（ACEI）在成年糖尿病患者中是首选的抗高血压治疗药物。该研究发表于10月24日的《英国医学杂志》（BMJ）。　　研究人员通过对PubMed、Medline、Scopus、Cochrane等数据的检索，分析了63项随机试验。这些试验在近37,000位患有糖尿病的成年人中评价了11种不同的降压治疗方案。研究终点

我国台湾学者简国龙、杜裕康等新近发表的一项荟萃分析显示，血管紧张素转换酶抑制剂（ACEI）在成年糖尿病患者中是首选的抗高血压治疗药物。该研究发表于10月24日的《英国医学杂志》（BMJ）【原文下载】。　　

研究人员通过对PubMed、Medline、Scopus、Cochrane等数据的检索，分析了63项随机试验。这些试验在近37,000位患有糖尿病的成年人中评价了11种不同的降压治疗方案。研究终点包括全因死亡率、终末期肾病，以及血清肌酐水平倍增。　　

结果显示：ACEI加钙通道阻滞剂联合治疗最有可能降低全因死亡率；β受体阻滞剂则显示死亡率明显上升。与安慰剂相比，只有ACEI能显著预防血清肌酐水平倍增的终点事件。ACEI与血管紧张素受体阻滞剂（ARB）的结果无显著差异，但作者指出，ACEI“在所有研究终点中获得较优排名的概率都较高”。　　

作者认为，现有证据未显示ARB类药物效果优于ACEI，考虑到医疗成本，ACEI应该是成年糖尿病患者的一线抗高血压治疗药物，并指出在单用ACEI不能控制血压时，可加用钙通道阻滞剂。　　

原文出处：

Wu HY, Huang JW, Lin HJ, Liao WC, Peng YS, Hung KY, Wu KD, Tu YK, Chien KL.Comparative effectiveness of renin-angiotensin system blockers and other antihypertensive drugs in patients with diabetes: systematic review and bayesian network meta-analysis.BMJ. 2013 Oct 24;347:f6008. doi: 10.1136/bmj.f6008.【原文下载】

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2014-01-07 shanyongle

#ACE#

58 0
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2014-04-01 gaoxiaoe

#BMJ#

35 0
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2013-11-01 经常头晕

#降压#

35 0
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2013-11-01 xue8604

#糖尿病患者#

36 0

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