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J INTERN MED:血管紧张素II受体阻断剂对血管紧张素转换酶抑制剂相关的血管神经性水肿患者是安全的

2018-12-18 xing.T MedSci原创

由此可见,与其他抗高血压药物相比,AT2s不会增加先前ACEi治疗相关的血管性水肿患者的血管性水肿的复发率。

长期以来,人们一直认为血管紧张素转换酶抑制剂(ACEi)和血管紧张素II受体阻断剂(AT2s)在引起血管性水肿方面具有一定程度的“交叉反应性”。因此,在将患有ACEi相关血管神经性水肿的患者转换为AT2时,建议谨慎对待。近日,内科学领域权威杂志Journal of Internal Medicine上发表一篇研究文章,该研究旨在明确AT2是否可以安全地用于ACEi治疗期间有血管性水肿病史的患者,并估计随后接受其他抗高血压药物(β-肾上腺素能受体阻断剂、钙通道阻滞剂、噻嗪类以及类似物)治疗或未进行降压治疗的患者血管性水肿的发生率。

这是一项全国性的回顾性基于1994年至2016年期间丹麦人群的队列研究,它使用了丹麦的健康登记处的数据,调整后的倾向得分以及传统的比例风险回归模型用于数据分析。

该研究确定了1106024名ACEi服用者。总共有5507名(0.5%)患者在ACEi治疗期间出现血管性水肿,并被纳入研究。最高的血管性水肿复发风险与持续服用ACEi相关,调整后的风险比为1.45(95%CI为1.19-1.78)。与其他抗高血压药相比,AT2s与血管神经性水肿(调整后的风险比为0.39; 95%CI为0.30-0.51)之间存在负相关(调整后风险比为0.77-0.97)。

由此可见,与其他抗高血压药物相比,AT2s不会增加先前ACEi治疗相关的血管性水肿患者的血管性水肿的复发率。

原始出处:

Eva Rye Rasmussen,et al.Angiotensin II receptor blockers are safe in patients with prior angioedema related to angiotensin converting enzyme inhibitors – a nation‐wide registry‐based cohort study.J INTERN MED. 2018. https://onlinelibrary.wiley.com/doi/10.1111/joim.12867

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    2019-02-27 jklm09
  4. 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CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589320, encodeId=8313158932068, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Thu Dec 20 14:54:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609387, encodeId=835d160938ef8, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, 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  5. 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CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1589320, encodeId=8313158932068, content=<a href='/topic/show?id=fb0389e4373' target=_blank style='color:#2F92EE;'>#血管紧张素#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=89743, encryptionId=fb0389e4373, topicName=血管紧张素)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=5ce517702394, createdName=xiongliangxl, createdTime=Thu Dec 20 14:54:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1609387, encodeId=835d160938ef8, content=<a href='/topic/show?id=eb6b1145939' target=_blank style='color:#2F92EE;'>#Med#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=11459, encryptionId=eb6b1145939, topicName=Med)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=hb2008ye, createdTime=Thu Dec 20 14:54:00 CST 2018, time=2018-12-20, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=355817, encodeId=ab9135581e23, content=学习谢谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=70, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/mStl88fu4Nd44v3xHnnictn9UpctwtH62EPQ59TMdI9lnqHMgQ16nH7GmGCfpzicsHgjibYVk6vwSpXrC86gMibRkoaIzf5HwSz7/0, createdBy=78cc1691107, createdName=龙胆草, createdTime=Wed Dec 19 10:05:26 CST 2018, time=2018-12-19, status=1, ipAttribution=)]
    2018-12-20 小华子
  6. 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  7. 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  8. 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    2018-12-20 hb2008ye
  10. 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    2018-12-19 龙胆草

    学习谢谢分享

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