Objective To search evidence of angiotensin-converting-enzyme inhibitors for microalbumin-uria in type 2 diabetes for guiding clinical practice. Methods We searched MEDLINE （ 1970 -Jun. 2005 ） to identify randomized controlled trials （RCT）of the effect on angiotensin-converting-enzyme inhibitors to prevent microalbuminuria in type 2 diabetes. Results One RCT （n =1 204）was identified. The result showed that angiotensin-converting-enzyme inhibitors were significantly more effective in prevention of microalbuminuria than other medicines in type 2 diabetes. However, angiotensin-converting-enzyme inhibitors may increase the risk of cardiac mortality. We explained the evidence to patients and they were satisfied with our explanation. Conclusions Angiotensin-converting-enzyme inhibitors can decrease the incidence of microalbuminuria in patients with type 2 diabetes and hypertension.
目的：了解糖尿病患者踝肱指數的影響因素。方法：采用多普勒血流探測儀測定68例糖尿病患者的踝肱指數(Anklebranchial index，ABI)，ABI比值小于0.9為低ABI組，大于1.3為高ABI組，在0.9到1.3之間(含1.3)為正常組。結果：本組病例中ABIlt; 0.9者11例，占16.18%，ABIgt; 1.3者8例，占11.76%。低ABI組與正常組比較，前者年齡大、病程長，其脈壓、HbA1C、TG、冠心病合并率、視網膜病變發生率明顯增高。高ABI組與正常組比較，前者年齡大、病程長，其脈壓、HbA1C、TG明顯增高，HDLC明顯降低。多因素logistic逐步回歸分析顯示年齡、病程是導致ABI異常的危險因素。結論：多個因素影響糖尿病踝肱指數變化。