心臟血管疾病與糖尿病腎病變

10.6666/ClinMed.201905_83(5).0049

翁宏嘉；黎思源

糖尿病腎病變 ； 心血管疾病 ； 危險因子 ； 藥物

臨床醫學月刊

83卷5期（2019 / 05 / 31）

294 - 299

繁體中文

糖尿病、腎臟病與心血管疾病有高度的相關性。高血壓與高血糖會增加心血管疾病的風險，積極的藥物控制對預後有顯著幫助。控制高血脂對心血管預防也有同樣效益；但對於腎臟保護的效果則不明顯。降血糖藥物推陳出新，其中sodiumglucoseco-transporter2（SGLT-2）、glucagonlikepeptide-1 agonists（GLP-1）兩種藥物對於心臟和腎臟都有保護的效果，能顯著降低糖尿病、腎臟病的併發症與死亡率。本篇主要介紹近年來對於糖尿病、腎病變與心血管併發症預防的藥物使用整理。

1. Brenner, BM,Cooper, ME,deZeeuw, D(2001).Effects of losartan on renal and cardiovascular outcomes inpatients with type 2 diabetes and nephropathy.N Engl J Med,345,861-869.
2. Cherng, YG,Lin, CS,Shih, CC(2018).Stroke risk and outcomes in patients with chronic kidney diseaseorend-stagerenal disease: two nationwide studies.PLoS One,13,e0191155.
3. Collins, R,Peto, R,Godwin, J(1990).Blood pressure and coronary heart disease.Lancet,336,370-371.
4. Fellström, BC,Jardine, AG,Schmieder, RE(2009).Rosuvastatin and cardiovascular events in patients undergoing hemodialysis.N Engl J Med,360,1395-1407.
5. Gerstein, HC,Miller, ME,Byington, RP(2008).Effects of intensive glucose lowering in type2 diabetes.N Engl J Med,358,2545-2559.
6. Hall, JE(1991).Control of blood pressure by therenin-angiotensin- aldosterone system.Clin Cardiol,14,IV6-IV21.
7. Imai, E,Chan, JC,Ito, S(2011).Effects of olmesartan on renal and cardiovascu laroutcomesintype2diabeteswithovert nephropathy: amulti centre, randomised, placebo-controlled study.Diabetologia,54,2978-2986.
8. Mann, JF,Schmieder, RE,McQueen, M(2008).Renal outcomes with telmisartan, ramipril, or both, in people at high vascular risk(the ONTAR GET study):a multicentre, randomised, double-blind, controlled trial.Lancet,372,547-553.
9. Maqbool, M,Cooper, ME,Jandeleit-Dahm, KAM(2018).Cardiovascular disease and diabetic kidney disease.Semin Nephrol,38,217-232.
10. National Kidney Foundation(2012).KDOQI Clinical Practice Guide- line for Diabetes and CKD:2012 update.Am J Kidney Dis,60,850-886.
11. Ogurtsova, K,da Rocha Fernandes, JD,Huang, Y(2017).IDF diabetes atlas: global estimates for the prevalence of diabetes for 2015 and 2040.Diabetes Res Clin Pract,128,40-50.
12. Palmer, SC,Strippoli, GFM,Craig, JC(2014).KHA-CARIcommen-tary on the KDIGO Clinical Practice Guideline for Lipid Management in Chronic Kidney Disease.Nephrology,19,663-666.
13. Pálsson, R,Patel, UD(2014).Cardiovascular complications of diabetic kidney disease. advances in chronic kidney disease.Adv Chronic Kidney Dis,21,273-280.
14. Parving, H-H,Persson, F,Lewis, JB(2008).Aliskiren combined with losartanintype2 diabetes and nephropathy.N Engl J Med,358,2433-2446.
15. Patel, A,Mac Mahon, S,Chalmers, J(2007).Effects of a fixed combination of perindopril and indapamide on macrovascular and microvascular outcomes in patients with type 2 diabetes mellitus (the ADVANCE trial): A randomized controlled trial.Lancet,370,829-840.
16. Pavlakou, P,Liberopoulos, E,Dounousi, E(2017).PCSK9 in chronic kidney disease.Int Urol Nephrol,49,1015-1024.
17. Sattar, N,Preiss, D,Robinson, JG(2016).Lipid-lowering efficacy of thePCSK9 inhibitor evolocumab(AMG145)in patients with type2 diabetes:a metaanalysis of individual patient data.Lancet Diabetes Endocrinol,4,403-410.
18. Schlondorff, D(1993).Cellular mechanisms of lipid injury in the glomerulus.Am J Kidney Dis,22,72-82.
19. Soliman, EZ,Prineas, RJ,Go, AS(2010).Chronic kidney disease and prevalent atrial fibrillation: the Chronic Renal Insufficiency Cohort(CRIC).Am Heart J,159,1102-1107.
20. Toto, RD(2005).Management of hypertensive chronic kidney disease: role of calcium channel blockers.J Clin Hypertens,7,15-20.
21. Zhang, XL,Zhu, QQ,Zhu, L(2015).Safety and efficacy ofanti- PCSK9 antibodies: ameta-analysis of 25 randomized,controlled trials.BMC Med,13,123.