临床研究：对于血压正常的糖尿病患者，血管紧张素转换酶抑制剂（ACE 抑制剂）或血管紧张素 II 受体阻滞剂（ARB）有助于预防肾脏疾病吗？
Clinical Inquiry: Do ACE inhibitors or ARBs help prevent kidney disease in patients with diabetes and normal BP?
作者信息
Trietley Gregory S, Wilson Stephen A, Chaudhri Parul, Payette Nicole, Higbea Ashley, Nashelsky Joan
机构信息
UPMC St. Margaret, Pittsburgh, PA, USA.
Texas Tech University Health Science Center, Dallas, USA.
出版信息
J Fam Pract. 2017 Apr;66(4):257-263.
Yes for angiotensin-converting enzyme (ACE) inhibitors, no for angiotensin receptor blockers (ARBs). A 2011 meta-analysis of 5 RCTs (total 2975 patients) that compared ACE inhibitor therapy with placebo in diabetic patients without hypertension and albuminuria found that ACE inhibitors reduced the risk of new-onset microalbuminuria or macroalbuminuria by 18% (relative risk [RR]=0.82; 95% confidence interval [CI], 0.73-0.92).
血管紧张素转换酶（ACE）抑制剂适用，血管紧张素受体阻滞剂（ARB）不适用。2011年一项对5项随机对照试验（共2975例患者）的荟萃分析比较了在无高血压和蛋白尿的糖尿病患者中ACE抑制剂治疗与安慰剂治疗，发现ACE抑制剂使新发微量白蛋白尿或大量白蛋白尿的风险降低了18%（相对危险度[RR]=0.82；95%置信区间[CI]，0.73 - 0.92）。
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