中心作用的ACE抑制剂 (cACEi) 和血管激素受体阻断剂 (cARB) 的使用和SLE患者的认知功能障碍
Chrisanna Dobrowolski1, Michelle Barraclough2,3,4, Jiandong Su4
1Division of Rheumatology, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.
Lupus science & medicine
|July 10, 2023
概括
中心作用的ACE抑制剂 (cACEi) 和ARBs在全身性红斑狼 (SLE) 患者中没有对认知功能障碍产生保护作用. 需要进一步的随机试验来证实这些发现用于SLE-CD治疗.
科学领域:
- 类风湿病学 类风湿病学
- 神经科学是一个神经科学.
- 药理学 药理学是指药理学的学科.
背景情况:
- 认知功能障碍 (CD) 影响大约40%的系统性红斑狼 (SLE) 患者.
- 目前,对于与SLE相关的CD.目前还没有批准的药理疗法.
- 动物初步研究表明,向微质激活可能是有益的,具有中央作用的ACE抑制剂 (cACEi) 和血管激素受体抑制剂 (cARB) 的潜在作用.
研究的目的:
- 研究cACEi/cARBs使用与人类SLE队列认知功能之间的关联.
- 为了确定cACEi/cARB的使用是否与SLE相关的CD的发病率或严重程度降低有关.
主要方法:
- 300名SLE患者的队列在基线,6个月和12个月使用美国风湿病学学院的神经心理电池进行了评估.
- 认知功能与性别和年龄匹配的对照组进行了比较.
- 用通用线性混合建模来分析基于累积cACEi/cARB剂量 (作为相当于拉米普里尔剂量) 的CD几率.
主要成果:
- 在300名SLE患者中,有116名 (39%) 患有CD. 53名参与者 (18%) 接受了cACEi或cARBs的治疗.
- 累计的cACEi/cARB剂量没有被发现对SLE-CD有保护作用.
- 白人种族,当前就业和阿扎西奥普林累积剂量与CD的几率降低有关,而较高的疲劳严重程度评分与CD的几率增加相关.
结论:
- 在这个单中心的SLE队列中,cACEi/cARB的使用与认知功能障碍的不存在无关.
- 这项回顾性研究中的潜在混因素可能影响了结果.
- 需要进行随机对照试验,以确定cACEi/cARB是否可以作为SLE相关CD的治疗.
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