ангиотензин转化酶抑制剂和大动脉破裂:一个基于人口的病例控制研究
Daniel G Hackam1, Deva Thiruchelvam, Donald A Redelmeier
1Clinical Epidemiology and Health Care Research Program, Department of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada. daniel.hackam@ices.on.ca
Lancet (London, England)
|August 22, 2006
概括
ангиотензин转化酶 (ACE) 抑制剂显著降低了65岁以上患者腹腔大动脉动脉瘤破裂的风险. 这种保护作用在其他常见的血压药物中没有被观察到.
科学领域:
- 心血管医学 心血管医学
- 药理学 药理学是指药理学的学科.
- 流行病学 流行病学
背景情况:
- 动物研究表明, ангиотензин转化酶 (ACE) 抑制剂可以防止大动脉动脉瘤扩张和破裂.
- 需要临床证据来确认ACE抑制剂与人类患者腹腔大动脉动脉瘤 (AAA) 破裂之间的关联.
研究的目的:
- 调查ACE抑制剂使用与被诊断患有腹部大动脉动脉瘤的患者中破裂风险之间的关联.
主要方法:
- 在加拿大安大略省使用链接的行政数据库进行了基于人口的病例控制研究.
- 这项研究包括了15326名65岁以上的患者,他们在1992年至2002年期间被诊断为破裂或完整的腹腔大动脉动脉瘤.
主要成果:
- 在入院前使用ACE抑制剂的患者出现破裂动脉瘤的可能性显著降低 (OR 0.82).
- 这种保护性关联在调整各种人口因素,并发病症和医疗保健利用情况后仍然保持一致.
- 对于其他抗高血压药物类别,包括β抑制剂,通道阻断剂和利尿剂,没有观察到类似的保护性关联.
结论:
- ACE 抑制剂与腹腔大动脉动脉瘤破裂的风险降低有关.
- 与其他抗高血压药物不同,ACE抑制剂在AAA破裂中发挥着潜在的保护作用.
- 随机对照试验调查ACE抑制剂用于AAA破裂预防是有必要的.
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