ACEI/ARB underused in patients with type 2 diabetes in Chinese population (CCMR-3B study).
ACEI/ARB underused in patients with type 2 diabetes in Chinese population (CCMR-3B study).
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ACEI/ARB 在中国人群 2 型糖尿病患者中未得到充分利用（CCMR-3B 研究）。
DOI：
10.1371/journal.pone.0116970
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发表时间：
2015
期刊：
影响因子：
3.7
通讯作者：
Zhang D
中科院分区：
文献类型：
--
作者：
Xie Q;Hao CM;Ji L;Hu D;Zhu T;Li X;Qin D;Zhang D
在糖尿病肾病患者中，有充分证据表明RAS阻断与结局改善相关。这项观察性、多中心研究调查了中国2型糖尿病（T2 DM）患者ACEI/ARB的“真实世界”使用情况。本研究使用了中国心脏代谢登记中心（CCMR-3B）中国T2 DM患者的血压、血脂和血糖数据。这项非干预性、观察性、横断面研究招募了连续6个月以上的门诊T2 DM患者。白蛋白尿定义为尿白蛋白肌酐比值（ACR）≥ 30 mg/g。共入组了来自中国6个地区的25，454例门诊T2 DM患者，47.0%为男性，59.8%患有高血压。其中6，383例患者测定了ACR，其中3，231例≥ 30 mg/L。在高血压患者中，73.0%的患者使用抗高血压药物，39.7%的患者使用ACEI/ARB。在2,157例高血压伴蛋白尿患者中，仅48.3%使用ACEI/ARB。在非高血压伴蛋白尿患者中，ACEI/ARB使用率<1%。多因素分析显示，合并症、地区、医院级别、医生专业和患者的教育水平与ACEI/ARB的使用相关。在中国T2 DM伴高血压和蛋白尿患者中，超过一半的患者未接受ACEI/ARB治疗。这一真实的世界证据表明，目前中国糖尿病合并高血压和蛋白尿患者的治疗是次优的。
In patients with diabetic kidney disease, it is well documented that RAS blockade is associated with an improved outcome. This observational, multicenter study examined the “real-world” use of ACEI/ARB in patients with type 2 diabetes (T2DM) in China. Data from the China Cardiometabolic Registries on blood pressure, blood lipid and blood glucose in Chinese T2DM patients (CCMR-3B) were used for the present study. Consecutive outpatients with T2DM for more than 6 months were recruited to this non-interventional, observational, cross-sectional study. Albuminuria was defined as urine albumin creatinine ratio (ACR) ≥ 30mg/g. A total of 25,454 outpatients with T2DM from 6 regions in China were enrolled, 47.0% were male, and 59.8% had hypertension. ACR was measured in 6,383 of these patients and 3,231 of them ≥ 30mg/L. Among patients with hypertension, 73.0% were on antihypertensives, and 39.7% used ACEI/ARB. Of the 2,157 patients with hypertension and albuminuria, only 48.3% used ACEI/ARB. Among the non-hypertensive patients with albuminuria, ACEI/ARB usage was < 1%. Multivariate analysis revealed that comorbidities, region, hospital tier, physician specialty and patient’s educational level were associated with ACEI/ARB use. In T2DM with hypertension and albuminuria in China, more than half of them were not treated with ACEI/ARB. This real world evidence suggests that the current treatment for patients with diabetes coexisting with hypertension and albuminuria in China is sub-optimal.
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作者：
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