血管紧张素受体拮抗剂（RAAS）抑制剂对高血压合并新冠肺炎急性低氧性呼吸衰竭和住院病死率的影响。
The effect of RAAS inhibitors on acute hypoxemic respiratory failure and in-hospital mortality in the hypertensive Covid-19 patients.
机构信息
Department of Cardiology, University of Health Sciences Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey.
Department of Chest Diseases, University of Health Sciences Diyarbakır Gazi Yaşargil Education and Research Hospital, Diyarbakır, Turkey.
出版信息
Clin Exp Hypertens. 2021 Oct 3;43(7):587-596. doi: 10.1080/10641963.2021.1916947. Epub 2021 May 6.
INTRODUCTION
We have aimed to investigate the relationship between use of angiotensin-converting-enzyme inhibitor (ACEI) or angiotensin-receptor-blocker (ARB) drugs and acute hypoxemic respiratory failure (AHRF) and in-hospital mortality in hypertensive Covid-19 patients.
MATERIAL AND METHOD
Consecutive 1345 patients diagnosed with Covid-19 between April and October 2020 who met inclusion criteria were divided into two groups based on presence and absence of AHRF and mortality. The groups were compared regarding epidemiological, clinical, radiological, laboratory findings and treatments methods. The patient groups ACEI, ARB and other antihypertensive drugs (non-ACEI/ARB) were compared regarding same parameters.
RESULTS
Median age was 68 (60-76) years in the patient group including 805 (59.9.1%) females. Of the patients, 475 (35.3%), 644 (47.9%) and 226 (16.8%) were using ACEIs, ARBs and non-ACEI/ARB, respectively. AHRF and in-hospital mortality developed in 1053 (78.3%) and 290 (21.6%) patients, respectively. Age, gender, coronary artery disease, diabetes mellitus (DM), neutrophil, lymphocyte, creatinine, D-dimer, C-reactive protein (CRP), ACEI, beta blocker and aspartate transaminase (AST) found statistically significant in the univariable logistic regression performed to identify independent predictors of mortality were included multivariable logistic regression model. Age (OR: 1.066, 95%CI: 1.049-1.083; < .001), DM (OR: 1.682, 95%CI: 1.238-2.286; = .001), neutrophil (OR: 1.041, 95%CI: 1.007-1.077; = .019), creatinine (OR: 1.178, 95%CI: 1.048-1.325; = .006), CRP (OR: 1.008, 95%CI: 1.006-1.010; < .001), ACEI (OR: 0.718, 95%CI: 0.521-0.988; = .042), AST (OR: 1.005, 95%CI: 1.001-1.010; = .010) were found associated with in-hospital mortality.
CONCLUSION
In our study, it was not detected clinically significant difference between three groups with regard to their relation with in-hospital mortality.
简介
我们旨在研究血管紧张素转换酶抑制剂（ACEI）或血管紧张素受体阻滞剂（ARB）药物的使用与高血压合并新冠肺炎患者急性低氧性呼吸衰竭（AHRF）和住院死亡率之间的关系。
材料与方法
连续纳入 2020 年 4 月至 10 月期间符合纳入标准的 1345 例确诊为新冠肺炎的患者，根据是否存在 AHRF 和死亡率将患者分为两组。比较两组患者的流行病学、临床、影像学、实验室检查和治疗方法。比较 ACEI、ARB 和其他降压药物（非 ACEI/ARB）组患者的相同参数。
结果
患者组中位年龄为 68（60-76）岁，其中 805 例（59.9.1%）为女性。患者中分别有 475 例（35.3%）、644 例（47.9%）和 226 例（16.8%）使用 ACEI、ARB 和非 ACEI/ARB。1053 例（78.3%）和 290 例（21.6%）患者发生 AHRF 和住院死亡率。在单变量逻辑回归中，年龄、性别、冠状动脉疾病、糖尿病（DM）、中性粒细胞、淋巴细胞、肌酐、D-二聚体、C 反应蛋白（CRP）、ACEI、β受体阻滞剂和天冬氨酸转氨酶（AST）在识别死亡率的独立预测因素方面具有统计学意义，这些因素被纳入多变量逻辑回归模型。年龄（OR：1.066，95%CI：1.049-1.083；<0.001）、DM（OR：1.682，95%CI：1.238-2.286；=0.001）、中性粒细胞（OR：1.041，95%CI：1.007-1.077；=0.019）、肌酐（OR：1.178，95%CI：1.048-1.325；=0.006）、CRP（OR：1.008，95%CI：1.006-1.010；<0.001）、ACEI（OR：0.718，95%CI：0.521-0.988；=0.042）、AST（OR：1.005，95%CI：1.001-1.010；=0.010）与住院死亡率相关。
结论
在我们的研究中，三组患者在与住院死亡率的关系方面未发现具有临床意义的差异。
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