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数的影响因素。方法：采用多普勒血流探测仪测定68例糖尿病患者的踝肱指数(Anklebranchial index，ABI)，ABI比值小于0.9为低ABI组，大于1.3为高ABI组，在0.9到1.3之间(含1.3)为正常组。结果：本组病例中ABIlt; 0.9者11例，占16.18%，ABIgt; 1.3者8例，占11.76%。低ABI组与正常组比较，前者年龄大、病程长，其脉压、HbA1C、TG、冠心病合并率、视网膜病变发生率明显增高。高ABI组与正常组比较，前者年龄大、病程长，其脉压、HbA1C、TG明显增高，HDLC明显降低。多因素logistic逐步回归分析显示年龄、病程是导致ABI异常的危险因素。结论：多个因素影响糖尿病踝肱指数变化。