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NEJM:肾素-血管紧张素系统阻滞剂与Covid-19风险

2020-06-18 MedSci原创 MedSci原创

在这项基于人群的大型研究中,由于Covid-19患者的心血管疾病患病率较高,因此在Covid-19患者中使用ACE抑制剂和ARB的比例高于对照者。没有证据表明ACE抑制剂或ARB会影响COVID风险。

血管紧张素受体阻滞剂(ARBs)和血管紧张素转化酶(ACE)抑制剂与2019冠状病毒疾病(Covid-19)风险之间的潜在关联尚未明确。

近日,顶级医学期刊NEJM上发表了一篇研究文章,研究人员在意大利伦巴第地区进行了一项基于人群的病例对照研究。在2020年2月21日至3月11日期间,研究人员共确定了6272例严重急性呼吸系统综合症冠状病毒2(SARS-CoV-2)感染的患者,根据性别、年龄和居住城市将其与30759名地区卫生服务的受益人(对照者)进行匹配。所选药物和患者的临床资料是从医疗保健使用数据库中获得。研究人员通过logistic回归估算药物与感染之间相关性的比值比和95%置信区间,并对混杂因素进行了调整。

在患者和对照者中,平均(±SD)年龄为68±13岁,女性为37%。与对照者相比,使用ACE抑制剂和ARB的患者更为常见,并且患者的临床状况较差。在所有病例患者(校正后的比值比ARBs为0.95 [95%置信区间{CI}为0.86至1.05]和ACE抑制剂为0.96 [95%CI为0.87至1.07])或患有严重或致命疾病的患者(ARB校正后比值比为0.83 [95%CI为0.63至1.10],ACEI抑制剂为0.91 [95%CI为0.69至1.21])中,ARBs或ACE抑制剂的使用均未显示与Covid-19风险之间存在任何关联 ,并且根据性别未发现这些变量之间的关联。

在这项基于人群的大型研究中,由于Covid-19患者的心血管疾病患病率较高,因此在Covid-19患者中使用ACE抑制剂和ARB的比例高于对照者。但是,没有证据表明ACE抑制剂或ARB会影响COVID-19的风险。

同期另一篇:NEJM:肾素-血管紧张素-醛固酮系统抑制剂与Covid-19风险

原始出处:

Giuseppe Mancia.et al.Renin–Angiotensin–Aldosterone System Blockers and the Risk of Covid-19.NEJM.2020.https://www.nejm.org/doi/full/10.1056/NEJMoa2006923

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    2021-01-29 zhyy88
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    2020-06-18 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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