培训课件-DN的早期防治.pptVIP

* * * * * * * * Ref 1: P.205S Col.1 Par.1 S.3-5; P.209S Col.1 Par.2 S.2-6; P.209S Col.2 Par.2 S.last; P.210S Col.2 Par.3 S.1 Ref 2: P.1632 Col.1 Par.5 S.2-6; P.1634 Col.1 Par.2 S.1-2,7-8 Ref 3: P.175 Col.1 Par.1 S.2 Ref 4: P.188 Col.1 Par.2 S.1 Slide 2: Consequences of Hypertension Hypertension can lead to a number of serious health problems. A person with hypertension is at increased risk for renal failure at an early age, myocardial infarction (MI), disabling or fatal left ventricular failure, sudden cardiac death, cerebral hemorrhage or infarction, and dementia.2-4 [Ref 2: P.1634 Col.1 Par.2 S.1-2; Ref 3: P.175 Col.1 Par.1 S.2; Ref 4: P.188 Col.1 Par.2 S.1] References: 1. Weir MR, Dzau VJ. The renin-angiotensin-aldosterone system: A specific target for hypertension management. Am J Hypertens 1999;12:205S-213S. 2. Arterial Hypertension. In: Beers MH, Berkow R, eds. The Merck Manual of Diagnosis and Therapy. 17th ed. Whitehouse Station, New Jersey: Merck Research Laboratories; 1999:1629-1648. 3. Francis CK. Pathogenesis of coronary artery disease. In: Izzo JL Jr, Black HR, eds. Hypertension Primer: The Essentials of High Blood Pressure. 2nd ed. Dallas, Texas: American Heart Association; 1999:175-176. 4. Hershey LA. Pathogenesis of vascular disease and mixed dementia. In: Izzo JL Jr, Black HR, eds. Hypertension Primer: The Essentials of High Blood Pressure. 2nd ed. Dallas, Texas: American Heart Association; 1999:188-189. * * * * * * * * * * * * * * * * * * * * * * * * * * * * 6 6 1 幻灯5 在一个328名白人NIDDM病人的前瞻性研究中，Gall等人研究的结果提示：在NIDDM病人中，在蛋白尿和所有原因的死亡率的危险之关存着一种关系，即随着蛋白尿的增加存活率降低。 * * * * * * * * * * * * * * * * * * * * * * ACEI，ARB， LPD延缓DN-CRF病程进展的作用 Effect of Diet ACEI，ARB on hyperfiltration 入球小动脉 AII，NPD ACEI，ARB， LPD 入球小动脉 出球小动脉 入球小动脉 出球小动脉 Effect of ACEI on CRF progression ACEI治疗对CRF进展的作用 Control ACEI 年 Years RENAAL首要终点 血清肌酐加倍 0 12 24 36 48 月 0 10 20 30 事件% p=0.006 危险性下降: 25% 751 692 583 329 52 52 52 52 52 52 762 689 554 295 36 36 36 36 36 36 P L P (+