雅施达在慢性肾病患者的应用要点.ppt

蒋红樱 主任医师 硕士生导师 目前担任的社会职务： 云南省医院管理协会肾脏病分会副主任委员 云南省医师协会肾脏病分会常委 云南省医学会肾脏病分会委员 承担科技厅、教育厅等科研课题8项 发表文章41篇： 其中SCI收录2篇，中华肾脏病杂志等北大核心期刊20余篇,第一作者30余篇 获奖： 获由“云南省人民政府”颁发的“科学技术进步奖”三等奖1项（排名4） 获云南省卫生科技进步三等奖1项（排名第1） 获“伍达观教育基金奖教金”三等奖1项 “云南省教育厅”颁发的“多媒体教育软件高等教育组”优秀奖1项。 此外，雅施达?还可以显著降低卒中合并CKD患者心血管事件。在PROGRESS研究的肾病亚组分析中证实，纳入1751例卒中合并慢性肾病的患者，结果显示，雅施达可使卒中风险下降35%，而主要心血管事件下降30% Abstract Chronic kidney disease (CKD) is associated with a high risk of cardiovascular disease, but evidence regarding the effectiveness of interventions to reduce that risk is lacking. The Perindopril Protection against Recurrent Stroke Study (PROGRESS) study enrolled 6105 participants with cerebrovascular disease and randomly allocated them to perindopril-based blood pressure-lowering therapy or placebo. Individuals with CKD were at approximately 1.5-fold greater risk of major vascular events, stroke, and coronary heart disease, and were more than twice as likely to die (all P or =0.002). Perindopril-based treatment reduced the risk of major vascular events by 30% and stroke by 35% among subjects with CKD, and the absolute effects of treatment were 1.7-fold greater for those with CKD than for those without. Considering patients with CKD and a history of cerebrovascular disease, perindopril prevented one stroke or other cardiovascular event among every 11 patients treated over five years. In conclusion, kidney function should be considered when determining the need for blood pressure lowering therapy in patients with cerebrovascular disease. * 1. HOPE Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular high-risk patients. N Engl J Med. 2000;342:145-153.2. EUROPA Investigators. Efficacy of perindopril in reduction of cardiovascular events among patients with stable coronary artery disease: Randomised, double-blind, placebo-controlled, multicentre trial (the EUROPA study). Lancet. 2003;362:782-788.3. PEACE Trial Investigators. Angiotensin-converting-enzyme