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JAHA：ACEi/ARB与COVID-19住院患者结局之间的关系

2022-05-23 MedSci原创 MedSci原创

ACEI/ARB患者结局Covid-19最新资讯
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在COVID-19住院的患者中，ACEi/ARB治疗与较低的炎症水平和较低的住院结局风险相关。需要进一步的临床试验来明确ACEI/ARB在COVID-19治疗中的作用。

到2021年6月，COVID-19全球大流行已导致全球超过1.7亿确诊感染病例和超过370万人死亡。血管紧张素转换酶抑制剂和血管紧张素受体阻滞剂(ACEi/ARB)的使用被认为通过调节血管紧张素转换酶2（SARS-CoV2的细胞进入受体）的水平来影响COVID-19的患病情况。

近日，心血管疾病领域权威杂志JAHA上发表了一篇研究文章，研究人员试图评估因COVID-19住院患者的ACEI/ARB、炎症生物标志物和患者结局之间的关联。

研究人员利用国际COVID-19炎症研究（ISIC）确定了2020年2月1日至2021年6月1日期间因有症状的COVID-19入院患者，并评估了院内使用ACEI/ARB以及全因死亡、需要通气和需要透析之间的关联。研究人员使用连续测量的血压和血清肌酐值的边际结构模型估计了ACEi/ARB对复合结局的因果效应。

在ISIC研究的2044名患者中，1686名患者符合纳入标准，其中398名（23.6%）患者在COVID-19住院期间至少接受了1次ACEI/ARB治疗。该研究的参与者中有215人死亡，407人需要机械通气，124人在住院期间需要透析。既往使用ACEi/ARB治疗与较低水平的可溶性尿激酶纤溶酶原激活剂受体和C反应蛋白相关。在多变量分析中，院内使用ACEI/ARB治疗与较低的院内死亡、机械通气或透析复合结局风险相关（调整后的风险比为0.49，95%CI[0.36–0.65]）。

由此可见，在COVID-19住院的患者中，ACEi/ARB治疗与较低的炎症水平和较低的住院结局风险相关。需要进一步的临床试验来明确ACEI/ARB在COVID-19治疗中的作用。

原始出处：

Michael Pan,et al.Angiotensin‐Converting Enzyme Inhibitors, Angiotensin II Receptor Blockers, and Outcomes in Patients Hospitalized for COVID‐19.JAHA.2021.https://www.ahajournals.org/doi/10.1161/JAHA.121.023535

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    2021-12-26 shanyongle

    #ACE#

    0

  2. [GetPortalCommentsPageByObjectIdResponse(id=1656107, encodeId=fecd165610e8c, content=<a href='/topic/show?id=2a011829d7' target=_blank style='color:#2F92EE;'>#ACE#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=89, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=1829, encryptionId=2a011829d7, topicName=ACE)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=635024767990, createdName=shanyongle, createdTime=Sun Dec 26 21:13:36 CST 2021, time=2021-12-26, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1268834, encodeId=52f91268834c4, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Tue Dec 14 06:13:36 CST 2021, time=2021-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1480060, encodeId=89bf1480060d4, content=<a href='/topic/show?id=f9e0530e169' target=_blank style='color:#2F92EE;'>#患者结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=53071, encryptionId=f9e0530e169, topicName=患者结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=faa67597457, createdName=ms5906905816781247, createdTime=Tue Dec 14 06:13:36 CST 2021, time=2021-12-14, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1079338, encodeId=129a10e933832, content=赞赞赞😁, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20201213/119346f11836400fa79356b67c4c1c1a/0887a9dc98db4b5786e6d3c6d4bd617a.jpg, createdBy=cb1f5444162, createdName=jeff007, createdTime=Sun Dec 12 23:20:52 CST 2021, time=2021-12-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1079322, encodeId=553810e932201, content=好难, beContent=null, objectType=article, channel=null, level=null, likeNumber=88, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=fa976393237, createdName=ms9000000107532796, createdTime=Sun Dec 12 21:04:49 CST 2021, time=2021-12-12, status=1, ipAttribution=)]
    2021-12-14 zhaohui6731

    #AHA#

    0

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    2021-12-14 ms5906905816781247

    #患者结局#

    0

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    2021-12-12 jeff007

    赞赞赞😁

    0

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    2021-12-12 ms9000000107532796

    好难

    0

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