高血压患者晚期经常出现心脑肾等靶器官损害,微量蛋白尿(MAU)是靶器官损害危险因素,可用有效措施预防和逆转高血压患者MAU的出现。MAU被认为与高血压、糖尿病患者的肾损害有关,可以预测这些患者的心血管事件。大量的临床研究数据显示降低MAU可以减少心血管事件,未来的研究应更多地关注如何发现更加有效的手段来预防高血压患者MAU及心血管事件的发生。
《国际循环》:高血压患者常合并靶器官损害。微量白蛋白尿(MAU)是靶器官损害的危险因素之一。目前, 我们是否有有效的手段来预防MAU发生或逆转其进展?
<International Circulation>: Hypertensive patients often suffer from the complication of organ damage, and microalbuminuria (MAU) is a risk factor for organ damage. Are there any truly effective measures to prevent and reverse the progress of MAU in hypertension patients presently? What can we do?
Ritz教授:微量白蛋白尿(MAU)的病因并不是单一的,因此我们目前有几个方面的干预手段。当然,首先应当进行非药物治疗,比如控制体重和限盐,这非常重要,也很有效。对糖尿病患者来讲,控制血压,尤其是应用RAS阻断药物是最重要的干预手段。当然,糖化血红蛋白(HbA1c)也是重要的干预靶点,以往我们低估了这一指标,而ADVANCE试验可能充分证明了HbA1c的重要性。干预MAU的手段有多种,不过健康的生活方式依然是基石。
Prof. Ritz: Well there are several approaches because there is not one single cause of the microalbuminuria. To start with the non direct therapies of course, weight loss, salt reduction which is very important and good interventions, blood pressure lowering and specifically the renin angiotensins are the most important interventions in the patient with diabetes. Of course hemoglobin A1c has an enormous impact that has been underestimated in the past, perhaps very well been documented in the ADVANCE study. But we have multiple approaches and the best is to have a healthy lifestyle.