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比较氯沙坦和氨氯地平对 COVID-19 合并原发性高血压患者结局的影响:一项随机临床试验。

Comparison of losartan and amlodipine effects on the outcomes of patient with COVID-19 and primary hypertension: A randomised clinical trial.

机构信息

Immunology Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

Network of Immunity in Infection, Malignancy and Autoimmunity (NIIMA), Universal Scientific Education and Research Network (USERN), Tehran, Iran.

出版信息

Int J Clin Pract. 2021 Jun;75(6):e14124. doi: 10.1111/ijcp.14124. Epub 2021 Mar 13.

Abstract

BACKGROUND

Controversy exists regarding the drug selection in hypertension (HTN) management in patients with COVID-19. This study aimed to compare the effects of losartan and amlodipine in patients with primary HTN and COVID-19.

METHODS

In this randomised clinical trial, hospitalised patients with COVID-19 and primary HTN were enrolled in the study. One arm received losartan, 25 mg, twice a day and the other arm received amlodipine, 5 mg per day for 2 weeks. The main outcomes were compare 30-day mortality rate and length of hospital stay.

RESULTS

The mean age of patients treated with losartan (N = 41) and amlodipine (N = 39) was 67.3 ± 14.8 and 60.1 ± 17.3 years, respectively (P value = .068). The length of hospital stay in losartan and amlodipine groups was 4.57 ± 2.59 and 7.30 ± 8.70 days, respectively (P value = .085). Also, the length of ICU admission in losartan and amlodipine group was 7.13 ± 5.99 and 7.15 ± 9.95 days, respectively (P value = .994). The 30-day mortality was two and five patients in losartan and amlodipine groups, respectively (P value = .241).

CONCLUSIONS

There was no priority in losartan or amlodipine administration in COVID-19 patients with primary HTN in decreasing mortality rate, hospital and ICU length stay. Further studies need to clarify the first-line anti-HTN medications in COVID-19.

摘要

背景

在伴有 COVID-19 的高血压(HTN)管理中,药物选择存在争议。本研究旨在比较氯沙坦和氨氯地平在原发性 HTN 合并 COVID-19 患者中的疗效。

方法

在这项随机临床试验中,将 COVID-19 合并原发性 HTN 的住院患者纳入研究。一组接受氯沙坦,25mg,每日两次;另一组接受氨氯地平,每日 5mg,治疗 2 周。主要结局为比较 30 天死亡率和住院时间。

结果

接受氯沙坦(N=41)和氨氯地平(N=39)治疗的患者平均年龄分别为 67.3±14.8 岁和 60.1±17.3 岁(P 值=0.068)。氯沙坦和氨氯地平组的住院时间分别为 4.57±2.59 天和 7.30±8.70 天(P 值=0.085)。此外,氯沙坦和氨氯地平组 ICU 入住时间分别为 7.13±5.99 天和 7.15±9.95 天(P 值=0.994)。氯沙坦和氨氯地平组的 30 天死亡率分别为 2 例和 5 例(P 值=0.241)。

结论

在降低死亡率、住院时间和 ICU 入住时间方面,氯沙坦或氨氯地平在 COVID-19 合并原发性 HTN 患者中的应用没有优先级。需要进一步的研究来阐明 COVID-19 中一线抗 HTN 药物。

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