血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体拮抗剂与 COVID-19 合并高血压患者的死亡率降低相关。
Renin-angiotensin system antagonists are associated with lower mortality in hypertensive patients with COVID-19.
机构信息
Interventional cardiology fellow, Minneapolis Heart Institure, Abbott Northwestern Hospital, USA.
Internal medicine resident, Abbott Northwestern Hospital, Minneapolis, Minnesota.
出版信息
Scott Med J. 2020 Nov;65(4):123-126. doi: 10.1177/0036933020949219. Epub 2020 Aug 17.
Abstract
The use of angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-receptor blockers (ARBs) in patients with Coronavirus 2019 (COVID-19) has been controversial. We performed a meta-analysis of all published studies that reported the outcomes of ACEIs/ARBs in patients with COVID-19. We included four observational studies (3,267 patients). The use of ACEIs/ARBs was associated with a similar risk of all-cause death (OR: 0.75, 95% CI [0.36, 1.57], p = 0.45). Sensitivity analysis including only hypertensive patients demonstrated a lower risk of death with ACEIs/ARBs use (OR: 0.57, 95% CI [0.32-0.98], p = 0.04). In conclusion, hypertensive patients with COVID-19 treated with ACEIs/ARBS have a lower mortality but further research is needed.
摘要
血管紧张素转换酶抑制剂（ACEIs）和血管紧张素受体阻滞剂（ARBs）在 2019 年冠状病毒（COVID-19）患者中的应用一直存在争议。我们对所有报告 ACEIs/ARBs 在 COVID-19 患者中的结局的已发表研究进行了荟萃分析。我们纳入了四项观察性研究（3267 例患者）。ACEIs/ARBs 的使用与全因死亡率的风险相似（OR：0.75，95%CI [0.36，1.57]，p=0.45）。仅包括高血压患者的敏感性分析显示，ACEIs/ARBs 的使用降低了死亡风险（OR：0.57，95%CI [0.32-0.98]，p=0.04）。总之，COVID-19 合并高血压的患者使用 ACEIs/ARBs 治疗可降低死亡率，但需要进一步研究。
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