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多学科德尔菲研究慢性病和2型糖尿病患者的残留风险
Alberto Ortiz1, Ana Cebrián2, Alfonso Soto3
1Departamento de Nefrología e Hipertensión Arterial, IIS-Fundación Jiménez Díaz UAM, Madrid, Spain.
Nefrologia
|September 13, 2025
概括
患有2型糖尿病 (T2DM) 和慢性病 (CKD) 的患者面临显著的残留风险. 多学科共识证实,结合关键的治疗方法和协调护理可以降低这些风险.
科学领域:
- 腎臟病學 (nephrology) 是一種醫學專業.
- 内分泌学 在内分泌学.
- 心血管医学 心血管医学
- 公共卫生 公共卫生
背景情况:
- 患有2型糖尿病 (T2DM) 和慢性病 (CKD) 的患者表现出持续的残留和心血管 (CV) 风险,尽管使用了标准疗法.
- 解决这一未满足的需求需要了解专家对风险管理和治疗策略的共识.
研究的目的:
- 评估有关T2DM和CKD患者持续残留风险的多学科专家共识的程度.
- 确定基于共识的治疗方法来管理这种残留风险.
主要方法:
- 采用了Delphi方法,涉及60名专家 (脏病学,内分泌学,初级保健) 的小组.
- 一个由78个陈述组成的调查问卷在两轮中被开发和完善,专家们在9个点的利克尔特级别上对其进行了评分.
- 共识被定义为在每个声明上达成预定义的协议水平.
主要成果:
- 在78个声明中,在53个声明中达成了多学科共识 (68%的协议).
- 在并发症,心血管事件和过早死亡的显著残留风险方面,达成了高度共识 (86.4%).
- 专家们一致认为,氨酸-血管酶系统阻断,SGLT2抑制剂 (iSGLT2) 和非类固醇矿物质皮质体受体对抗剂 (mRNA) 的互补作用,iSGLT2和ARMn的益处,以及避免治疗惯性和协调护理的重要性.
结论:
- 多学科专家达成共识,T2DM和CKD患者具有疾病进展,过早死亡和/心血管并发症的高残留风险.
- 同时实施三个关键的治疗支柱,积极管理以避免治疗惯性,以及跨层次的护理协调对于减轻这种残留风险至关重要.
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