Hypertension:叶酸治疗对高血压患者新发蛋白尿的影响!

2017-06-15 xing.T MedSci原创

总之,依那普利-叶酸治疗,与依那普利相比,能显著降低糖尿病高血压患者蛋白尿的发生。

近日,心血管权威杂志Hypertension上发表了一篇研究文章,研究人员旨在检验一个假设,即在高血压患者中,采用依那普利和叶酸对预防新发蛋白尿的作用要比单独采用依那普利更有效。这是对中国脑卒中一级预防试验(CSPPT)进行的一项事后分析。

该研究共有13071名满足条件的无蛋白尿患者,被随机分配接受双盲的每日含10mg依那普利和0.8mg叶酸(n=6511)或10mg依那普利(n=6560)单一片剂治疗。该研究的主要结局为新出现的蛋白尿,其定义为在随访结束尿试纸读数≥1+。该研究的次要结局包括主要结局和全因死亡的复合以及估计肾小球滤过率下降的年速率。

经过中位4.4年的治疗后,在依那普利和依那普利-叶酸组该研究的主要事件发生分别有213名(3.9%)和188名(3.5%)参与者(比值比为0.90,95%可信区间为0.74-1.11)。然而,在基础的糖尿病参与者中,叶酸治疗可以显著降低的主要事件(依那普利-叶酸组为3.7%,依那普利组为7.4%,比值比为0.48;95%可信区间为0.29-0.81)和复合事件(比值比为0.62;95%可信区间为0.42-0.92)的发生风险,并且估计肾小球滤过率下降的年速率减慢了55%(每年为0.5% vs. 1.1%;P=0.002)。在那些基础没有糖尿病的参与者中,所有结局中组间均没有差异。

总之,依那普利-叶酸治疗,与依那普利相比,能显著降低糖尿病高血压患者蛋白尿的发生。

原始出处:

Youbao Li,et al. Effects of Folic Acid Therapy on the New-Onset Proteinuria in Chinese Hypertensive Patients A Post Hoc Analysis of the Renal Substudy of CSPPT (China Stroke Primary Prevention Trial).Hypertension. 2017.https://doi.org/10.1161/HYPERTENSIONAHA.117.09404

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    2018-02-27 feather89
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  5. 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likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuK7MtpefUjs5gdyd9SPjFgf48Ev1UPCfuRGKO8dL46bCN6ynydTWnVZjOk6KvWloBvRbiatjYgMag/0, createdBy=4f2b1931429, createdName=1e0cdf4em36(暂无匿称), createdTime=Thu Jun 15 14:56:07 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211137, encodeId=4e9621113eb9, content=不错的,学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Thu Jun 15 14:37:07 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211124, encodeId=3953211124ba, content=不要随便用叶酸治疗吗?叶酸治疗有风险?, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Thu Jun 15 14:07:34 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-16 lou.minghong

    学习

    0

  6. 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likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuK7MtpefUjs5gdyd9SPjFgf48Ev1UPCfuRGKO8dL46bCN6ynydTWnVZjOk6KvWloBvRbiatjYgMag/0, createdBy=4f2b1931429, createdName=1e0cdf4em36(暂无匿称), createdTime=Thu Jun 15 14:56:07 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211137, encodeId=4e9621113eb9, content=不错的,学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Thu Jun 15 14:37:07 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211124, encodeId=3953211124ba, content=不要随便用叶酸治疗吗?叶酸治疗有风险?, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Thu Jun 15 14:07:34 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-15 1ddf0692m34(暂无匿称)

    学习了,涨知识

    0

  7. 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likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/NUyjXTCJjo6KcicAVC1MwuK7MtpefUjs5gdyd9SPjFgf48Ev1UPCfuRGKO8dL46bCN6ynydTWnVZjOk6KvWloBvRbiatjYgMag/0, createdBy=4f2b1931429, createdName=1e0cdf4em36(暂无匿称), createdTime=Thu Jun 15 14:56:07 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211137, encodeId=4e9621113eb9, content=不错的,学习了,谢谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=39, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4NdqKgfW3nMpOkC3jXxiaW2po0PtglY5ZuVjERqKADW4HyMI8bcZXWlKgH7tEP9ULBoBzuQMibia4pr1s9rQPqLvqQJ/0, createdBy=e8c02060444, createdName=中医痴, createdTime=Thu Jun 15 14:37:07 CST 2017, time=2017-06-15, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=211124, encodeId=3953211124ba, content=不要随便用叶酸治疗吗?叶酸治疗有风险?, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Thu Jun 15 14:07:34 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-15 flysky120

    学习一下知识了,谢谢

    0

  8. 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encodeId=3953211124ba, content=不要随便用叶酸治疗吗?叶酸治疗有风险?, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Thu Jun 15 14:07:34 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-15 1e0cdf4em36(暂无匿称)

    谢谢学习了

    0

  9. 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encodeId=3953211124ba, content=不要随便用叶酸治疗吗?叶酸治疗有风险?, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Thu Jun 15 14:07:34 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-15 中医痴

    不错的,学习了,谢谢分享!

    0

  10. 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encodeId=3953211124ba, content=不要随便用叶酸治疗吗?叶酸治疗有风险?, beContent=null, objectType=article, channel=null, level=null, likeNumber=26, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/oLAjfB7s1ib260FNcic8ThYZTmbW36JHpvHcnIog7VbWIQjibo1kwuH9obXRJJtqHn1hYHHLG0DpIMIBVFPhBBpQOJWDk1rbib2Y/0, createdBy=d27274268, createdName=sillywu, createdTime=Thu Jun 15 14:07:34 CST 2017, time=2017-06-15, status=1, ipAttribution=)]
    2017-06-15 sillywu

    不要随便用叶酸治疗吗?叶酸治疗有风险?

    0