观察老年高血压患者非心脏手术围术期ACEI/ARB类药物不同使用策略与围术期低血压事件发生率及心血管不良事件之间的关系: 一项前瞻性、多中心、随机、双盲、对照研究

注册号:

Registration number:

ChiCTR2000039376 

最近更新日期:

Date of Last Refreshed on:

2025-04-21 10:40:06 

注册时间:

Date of Registration:

2020-10-25 00:00:00 

注册号状态:

预注册

Registration Status:

Prospective registration

注册题目:

观察老年高血压患者非心脏手术围术期ACEI/ARB类药物不同使用策略与围术期低血压事件发生率及心血管不良事件之间的关系: 一项前瞻性、多中心、随机、双盲、对照研究

Public title:

Effect of different use strategies of angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers on perioperative hypotension and adverse cardiovascular events in older patients undergoing noncardiac surgery: a prospective, multicenter, randomized, double-blind, controlled trial

注册题目简写:

English Acronym:

研究课题的正式科学名称:

老年患者非心脏手术前停用或继续使用ACEI/ARB类药物对围术期低血压事件及心血管不良事件的影响: 一项多中心、随机、双盲、对照研究

Scientific title:

Effect of withholding versus continuing angiotensin-converting enzyme inhibitors or angiotensin II receptor blockers on perioperative hypotension and adverse cardiovascular events in elderly patients undergoing noncardiac surgery: a multicenter, randomized, double-blind, controlled trial

研究课题代号(代码):

Study subject ID:

在二级注册机构或其它机构的注册号:

The registration number of the Partner Registry or other register:

申请注册联系人:

杨宇帆 

研究负责人:

嵇富海 

Applicant:

Yufan Yang 

Study leader:

Fuhai Ji 

申请注册联系人电话:

Applicant telephone:

+86 17706139957

研究负责人电话:

Study leader's
telephone:

+86 13656207331

申请注册联系人传真 :

Applicant Fax:

研究负责人传真:

Study leader's fax:

申请注册联系人电子邮件:

Applicant E-mail:

253087615@qq.com

研究负责人电子邮件:

Study leader's E-mail:

253087615@qq.com

申请单位网址(自愿提供):

Applicant website(voluntary supply):

研究负责人网址(自愿提供):

Study leader's website(voluntary supply):

申请注册联系人通讯地址:

中国江苏省苏州市平海路899号

研究负责人通讯地址:

中国江苏省苏州市平海路899号

Applicant address:

899 Pinghai Road, Suzhou, Jiangsu, China

Study leader's address:

899 Pinghai Road, Suzhou, Jiangsu, China

申请注册联系人邮政编码:

Applicant postcode:

研究负责人邮政编码:

Study leader's postcode:

申请人所在单位:

苏州大学附属第一医院

Applicant's institution:

The First Affiliated Hospital of Suzhou University

研究负责人所在单位:

苏州大学附属第一医院

Affiliation of the Leader:

The First Affiliated Hospital of Suzhou University

是否获伦理委员会批准:

Approved by ethic committee:

Yes

伦理委员会批件文号:

Approved No. of ethic committee:

(2020)伦审批第077-1号

伦理委员会批件附件:

Approved file of Ethical Committee:

查看附件View

批准本研究的伦理委员会名称:

苏州大学附属第一医院医学伦理委员会

Name of the ethic committee:

Ethics Committee of the First Affiliated Hospital of Suzhou University

伦理委员会批准日期:

Date of approved by ethic committee:

2020-09-01 00:00:00

伦理委员会联系人:

吴霜杰

Contact Name of the ethic committee:

Shuangjie Wu

伦理委员会联系地址:

中国江苏省苏州市平海路899号

Contact Address of the ethic committee:

899 Pinghai Road, Suzhou, Jiangsu, China

伦理委员会联系人电话:

Contact phone of the ethic committee:

伦理委员会联系人邮箱:

Contact email of the ethic committee:

研究实施负责(组长)单位:

苏州大学附属第一医院麻醉科

Primary sponsor:

Department of Anesthesiology, the First Affiliated Hospital of Soochow University

研究实施负责(组长)单位地址:

中国江苏省苏州市平海路899号

Primary sponsor's address:

899 Pinghai Road, Suzhou, Jiangsu, China

试验主办单位(项目批准或申办者):

Secondary sponsor:

国家:

中国

省(直辖市):

江苏

市(区县):

苏州

Country:

China

Province:

Jiangsu

City:

Suzhou

单位(医院):

苏州大学附属第一医院

具体地址:

平海路899号

Institution
hospital:

The First Affiliated Hospital of Suzhou University

Address:

899 Pinghai Road

经费或物资来源:

中国国家自然科学基金,江苏省自然科学基金,科技发展计划临床研究项目,江苏省青年医学人才

Source(s) of funding:

National Natural Science Foundation of China, Natural Science Foundation of Jiangsu Province, Science and Technology Development Plan Clinical Trial Project, Jiangsu Provincial Medical Youth Talent

研究疾病:

ACEI/ARB对老年非心脏手术患者的影响  

Target disease:

Effect of ACEI/ARB in older patients undergoing noncardiac surgery

研究疾病代码:

Target disease code:

研究类型:

干预性研究

Study type:

Interventional study

研究所处阶段:

其它 

Study phase:

N/A

研究设计:

随机平行对照 

Study design:

Parallel 

研究目的:

观察老年高血压患者非心脏手术术前停用或继续使用ACEI/ARB类药物是否会影响围术期低血压事件发生率、心血管不良事件的发生率,以及术后30天的临床结局。  

Objectives of Study:

To determine whether withholding or continuing angiotensin-converting enzyme inhibitors (ACEI)/angiotensin II receptor blockers (ARB) in elderly patients with hypertension before noncardiac surgery will affect the incidence of perioperative hypotension, adverse cardiovascular events, and clinical outcomes 30 days after surgery.

药物成份或治疗方案详述:

 

Description for medicine or protocol of treatment in detail:

 

纳入标准:

Inclusion criteria

排除标准:

1. 怀孕; 2. ACEI/ARB 仅在晚上使用,间断ACEI/ARB 使用,或ACEI和ARB同时使用; 3. 不能控制的高血压(收缩压≥180 mmHg 或舒张压≥110 mm Hg); 4. 基础平均动脉压力 ≤ 65 mmHg; 5. 静脉使用血管活性药物; 6. 严重心肺或脑血管疾病; 7. 肝或肾功能障碍 (Child-Pugh分级 ≥ B, 肌酐≥ 200 μmol/L); 8. 拒绝参与。

Exclusion criteria:

1. Pregnant objects; 2. ACEI / ARB is used only at night, intermittently, or both; 3. Patients with uncontrollable hypertension (systolic blood pressure >= 180 mmHg or diastolic blood pressure >= 110 mmHg); 4. Patients with mean basal arterial pressure <= 65 mmHg; 5. Patients who use vasoactive drugs intravenously; 6. Patients with severe cardiopulmonary or cerebrovascular diseases; 7. Patients with liver or kidney dysfunction (child Pugh grade >= B, creatinine >= 200 μ mol / L); 8. Patients who refused to participate.

研究实施时间:

Study execute time:

From 2020-11-01 00:00:00 To 2023-12-31 00:00:00  

征募观察对象时间:

Recruiting time:

From 2020-11-01 00:00:00 To 2023-12-31 00:00:00

干预措施:

Interventions:

组别:

ACEI/ARB继续组

样本量:

1018

Group:

Group ACEI/ARB continued

Sample size:

干预措施:

术晨常规继续服用ACEI/ARB

干预措施代码:

Intervention:

ACEI / ARB taken routinely in the morning of operation

Intervention code:

组别:

ACEI/ARB暂停组

样本量:

1018

Group:

Group ACEI/ARB withheld

Sample size:

干预措施:

术晨暂停ACEI/ARB

干预措施代码:

Intervention:

ACEI / ARB withheld in the morning of operation

Intervention code:

研究实施地点:

Countries of recruitment and research settings:

国家:

中国

省(直辖市):

江苏 

市(区县):

苏州 

Country:

China

Province:

Jiangsu

City:

Suzhou

单位(医院):

苏州大学附属第一医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Suzhou University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

上海 

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

复旦大学附属肿瘤医院 

单位级别:

三甲 

Institution
hospital:

Fudan University Shanghai Cancer Center

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

上海 

市(区县):

上海 

Country:

China

Province:

Shanghai

City:

Shanghai

单位(医院):

复旦大学附属中山医院 

单位级别:

三甲 

Institution
hospital:

Zhongshan Hospital Affiliated to Fudan University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

河南 

市(区县):

郑州 

Country:

China

Province:

He'nan

City:

Zhengzhou

单位(医院):

郑州大学第一附属医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Zhengzhou University

Level of the institution:

Tertiary A

国家:

中国

省(直辖市):

安徽 

市(区县):

合肥 

Country:

China

Province:

Anhui

City:

Hefei

单位(医院):

安徽医科大学第一附属医院 

单位级别:

三甲 

Institution
hospital:

The First Affiliated Hospital of Anhui Medical University

Level of the institution:

Tertiary A

测量指标:

Outcomes:

指标中文名:

围术期低血压事件

指标类型:

主要指标

Outcome:

perioperative hypotension events

Type:

Primary indicator

测量时间点:

术中和在PACU

测量方法:

Measure time point of outcome:

during surgery and in PACU

Measure method:

指标中文名:

围手术期低血压的持续时间

指标类型:

次要指标

Outcome:

Duration of perioperative hypotension

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

静脉输液和血管升压药的使用

指标类型:

次要指标

Outcome:

Use of intravenous fluids and vasopressors

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后3天内在病房发生的低血压事件

指标类型:

次要指标

Outcome:

Postoperative hypotension events occurring in the surgical wards within 3 days after surgery

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

围手术期神经认知障碍

指标类型:

次要指标

Outcome:

Perioperative neurocognitive disorders

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

主要的不良心脑事件

指标类型:

次要指标

Outcome:

Major adverse cardiocerebral events

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后30天内死亡率

指标类型:

次要指标

Outcome:

Mortality within 30 days after surgery

Type:

Secondary indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术中,苏醒室和术后3天内高血压事件的发生率(平均动脉压> 110 mmHg或平均动脉压较基线增加≥30%)

指标类型:

附加指标

Outcome:

The incidence of hypertension events (MAP > 110 mmHg or ≥ 30% increase in MAP from baseline) during surgery, in the PACU, and within 3 postoperative days

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

心动过速和心动过缓事件(心率> 100次/分钟,心率<50次/分钟)

指标类型:

附加指标

Outcome:

Tachycardia and bradycardia events defined as heart rate (HR) >100 beats/min and HR < 50 beats/min

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术中不良事件(心律失常,缺氧,过敏反应,大出血,体温过高,体温过低,少尿,酸碱紊乱,电解质紊乱,乳酸性酸中毒 ,心脏骤停)

指标类型:

附加指标

Outcome:

Intraoperative adverse events (arrythmia, hypoxia, allergic reaction, major bleeding, hyperthermia, hypothermia, oliguria, acid-base disturbances, electrolyte disorders, lactic acidosis, and cardiac arrest)

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

苏醒室中的Ramsay镇静分数

指标类型:

附加指标

Outcome:

Ramsay sedation scores in the PACU

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

苏醒室和术后3天内疼痛数字评分,止痛药的用量以及术后恶心和呕吐

指标类型:

附加指标

Outcome:

Numerical rating scale scores for pain, analgesic consumption, and postoperative nausea and vomiting in the PACU and in the wards within 3 postoperative days

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

重症监护病房的使用

指标类型:

附加指标

Outcome:

Intensive care unit admission

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

指标中文名:

术后住院时间

指标类型:

附加指标

Outcome:

Length of postoperative hospital stay

Type:

Additional indicator

测量时间点:

测量方法:

Measure time point of outcome:

Measure method:

采集人体标本:

Collecting sample(s)
from participants:

标本中文名:

血液

组织:

Sample Name:

Blood

Tissue:

人体标本去向

使用后销毁  

说明

Fate of sample:

Destruction after use  

Note:

征募研究对象情况:

Recruiting status:

结束

/Completed

年龄范围:

Participant age:

最小 Min age 60 years
最大 Max age 80 years

性别:

男女均可

Gender:

Both

随机方法(请说明由何人用什么方法产生随机序列):

由不参与后续研究或数据管理的独立生物统计学家产生比例为1:1的随机序列,区组大小为2和4,并且根据研究中心进行了分层。

Randomization Procedure (please state who generates the random number sequence and by what method):

An independent biostatistician who is not involved in the following study or data management generated a randomization sequence with a 1:1 ratio, permuted block sizes of 2 and 4, and stratification according to study center.

是否公开试验完成后的统计结果:

Calculated Results after the Study Completed public access:

不公开/Private

盲法:

根据随机代码,一名独立的研究护士将研究药物(ACEI/ARB或无效的安慰剂)准备在一样的胶囊中,并放在标有研究编号和“降压药”的袋子中。符合资格标准的受试者将被随机分配到ACEI/ARB继续组或ACEI/ARB暂停组。 参与者、麻醉医生、外科医生、负责数据收集的研究人员、以及其他医疗保健提供者将对治疗分配保持屏蔽,直到完成最终分析为止。

Blinding:

According to the random codes, an independent research nurse will prepare the study medications (either ACEI/ARBs or inactive placebos) in identical capsules, which were kept in bags labelled with the study numbers and "Antihypertensive agent". Subjects who meet the eligibility criteria will be randomly assigned to either an ACEI/ARB continued group or an ACEI/ARB withheld group. The participants, anesthesiologists, surgeons, investigators responsible for data collection, and other healthcare providers will remain masked to treatment allocation until the completion of final analysis.

是否共享原始数据:

IPD sharing

是Yes

共享原始数据的方式(说明:请填入公开原始数据日期和方式,如采用网络平台,需填该网络平台名称和网址):

请联系:253087615@qq.com

The way of sharing IPD”(include metadata and protocol, If use web-based public database, please provide the url):

Please contact: 253087615@qq.com

数据采集和管理(说明:数据采集和管理由两部分组成,一为病例记录表(Case Record Form, CRF),二为电子采集和管理系统(Electronic Data Capture, EDC),如ResMan即为一种基于互联网的EDC:

先制作病例记录表CRF,之后导入电子采集和管理系统EDC

Data collection and Management (A standard data collection and management system include a CRF and an electronic data capture:

Data collection and management includes a CRF and an EDC system

数据与安全监察委员会:

Data and Safety Monitoring Committee:

有/Yes

注册人:

Name of Registration:

 2020-10-25 22:53:07