1例2型糖尿病患者蛋白尿的循证防治

目的检索应用血管紧张素转换酶抑制剂防治2型糖尿病患者蛋白尿的临床证据,以指导临床实践.方法计算机检索MEDLINE(1970～2005.6)关于血管紧张素转换酶抑制剂对2型糖尿病患者蛋白尿防治效果的随机对照试验.结果检索到1篇随机对照试验,纳入1 204例患者.结果显示,血管紧张素转换酶抑制剂可阻止2型糖尿病患者发生蛋白尿,效果明显优于其他药物,但此类药物也是引起心血管不良反应甚至死亡的主要危险因素.应用此证据为患者释疑,患者表示满意.结论血管紧张素转换酶抑制剂可以阻止高血压及2型糖尿病患者的肾功能损害.

Evidence-based Prevention and Treatment of Microalbuminuria in Patient with Type 2 Diabetes

Objective To search evidence of angiotensin-converting-enzyme inhibitors for microalbumin-uria in type 2 diabetes for guiding clinical practice. Methods We searched MEDLINE (1970Jun.2005) to identify randomized controlled trials (RCT) of the effect on angiotensin-converting-enzyme inhibitors to prevent microalbuminuria in type 2 diabetes. Results One RCT (n=1 204) was identified. The result showed that angiotensin-converting-enzyme inhibitors were significantly more effective in prevention of microalbuminuria than other medicines in type 2 diabetes. However, angiotensin-converting-enzyme inhibitors may increase the risk of cardiac mortality. We explained the evidence to patients and they were satisfied with our explanation. Conclusions Angiotensin-converting-enzyme inhibitors can decrease the incidence of microalbuminuria in patients with type 2 diabetes and hypertension.