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血管紧张素受体阻滞剂和血管紧张素转换酶抑制剂对新型冠状病毒肺炎的影响。

Effects of angiotensin receptor blockers and angiotensin-converting enzyme inhibitors on COVID-19.

作者信息

Li Xiao-Long, Li Tao, Du Qi-Cong, Yang Li, He Kun-Lun

机构信息

Department of Diagnostic Radiology, PLA General Hospital, Beijing 100853, China.

Department of Radiology, The First Medical Center of PLA General Hospital, Beijing 100853, China.

出版信息

World J Clin Cases. 2021 Jul 16;9(20):5462-5469. doi: 10.12998/wjcc.v9.i20.5462.

Abstract

BACKGROUND

The World Health Organization reported that 28637952 people worldwide had been infected with severe acute respiratory syndrome coronavirus 2, the causative agent of coronavirus disease 2019 (COVID-19), by September 13.

AIM

The aim was to investigate whether long-term use of renin-angiotensin-aldosterone system (RAAS) inhibitors for the treatment of hypertension aggravates the performance of COVID-19 patients with hypertension.

METHODS

This was a retrospective analysis of lung computed tomography (CT) data and laboratory values of COVID-19 patients with hypertension who were admitted to Huoshenshan Hospital, Wuhan, Hubei Province, between February 18 and March 31, 2020. Patients were divided into two groups. Group A included 19 people who were long-term users of RAAS inhibitors for hypertension; and group B included 28 people who were randomly selected from the database and matched with group A by age, sex, basic diseases, and long-term use of other antihypertensive drugs. All patients underwent a series of CT and laboratory tests. We compared the most severe CT images of the two groups and the laboratory examination results within 2 d of the corresponding CT images.

RESULTS

The time until the most severe CT images from the onset of COVID-19 was 30.37 ± 14.25 d group A and 26.50 ± 11.97 d in group B. The difference between the two groups was not significant ( = 1.01, = 0.32). There were no significant differences in blood laboratory values, C-reactive protein, markers of cardiac injury, liver function, or kidney function between the two groups. There was no significant difference in the appearance of the CT images between the two groups. The semiquantitative scores of each involved lobe were 11.84 ± 5.88 in group A and 10.36 ± 6.04 group B. The difference was not significantly different ( = 0.84, = 0.41).

CONCLUSION

Chest CT is an important imaging tool to monitor the characteristics of COVID-19 and the degree of lung injury. Chronic use of RAAS inhibitors is not related to the severity of COVID-19, and it does not worsen the clinical process.

摘要

背景

世界卫生组织报告称,截至9月13日,全球已有28637952人感染了严重急性呼吸综合征冠状病毒2,即2019冠状病毒病(COVID-19)的病原体。

目的

旨在研究长期使用肾素-血管紧张素-醛固酮系统(RAAS)抑制剂治疗高血压是否会加重高血压COVID-19患者的病情。

方法

这是一项对2020年2月18日至3月31日期间入住湖北省武汉市火神山医院的高血压COVID-19患者的肺部计算机断层扫描(CT)数据和实验室检查值进行的回顾性分析。患者分为两组。A组包括19名长期使用RAAS抑制剂治疗高血压的患者;B组包括从数据库中随机选取的28名患者,这些患者在年龄、性别、基础疾病以及是否长期使用其他降压药物方面与A组相匹配。所有患者均接受了一系列CT和实验室检查。我们比较了两组最严重的CT图像以及相应CT图像后2天内的实验室检查结果。

结果

从COVID-19发病到出现最严重CT图像的时间,A组为30.37±14.25天,B组为26.50±11.97天。两组之间的差异无统计学意义(t = 1.01,P = 0.32)。两组患者的血液实验室检查值、C反应蛋白、心脏损伤标志物、肝功能或肾功能均无显著差异。两组CT图像表现无显著差异。A组各受累肺叶的半定量评分为11.84±5.88,B组为10.36±6.04。差异无统计学意义(t = 0.84,P = 0.41)。

结论

胸部CT是监测COVID-19特征和肺损伤程度的重要影像学工具。长期使用RAAS抑制剂与COVID-19的严重程度无关,也不会使临床病程恶化。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/07f9/8281418/79a30074b2bb/WJCC-9-5462-g001.jpg

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