在一项随机对照试验中,在COVID-19中停止使用氨酶系统抑制剂并没有改变系统ACE2
Vincent Rathkolb1, Marianna T Traugott2, Andreas Heinzel1
1Department of Internal Medicine III, Clinical Division of Nephrology & Dialysis, Medical University of Vienna, Wien, Austria.
iScience
|October 23, 2023
概括
在COVID-19期间继续服用氨酸-血管酶系统 (RAS) 抑制剂 (RASi) 是安全的,临床结果或血管酶转化酶2 (ACE2) 水平没有显著差异. 在停止治疗时观察到RAS代谢物变化.
科学领域:
- 心脏病学 心脏病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 氨酶系统抑制剂 (RASi) 对于管理高血压至关重要.
- 对RASi延续与停止对COVID-19患者的血管酶转化酶2 (ACE2) 和RAS代谢物的影响尚不清楚.
- 以前的研究表明类似的临床结果,但缺乏详细的代谢数据.
研究的目的:
- 对高血压COVID-19患者的ACE2和RAS代谢物的RASi延续与转换为非RASi药物的影响进行调查.
- 评估在COVID-19感染期间继续RASi的安全性.
主要方法:
- 奥地利冠状病毒适应性临床试验 (ACOVACT) 随机对高血压COVID-19患者进行的一项子研究.
- 患者被分配到RASi延续 (n=30) 或切换到非RASi (n=29).
- 使用混合线性回归分析了RAS代谢物;也测量了ACE2水平.
主要成果:
- 在RASi继续和戒断组之间,持续的临床改善或ACE2水平的时间没有显著差异.
- 在这两组中,ACE2水平随着时间的推移而增加,在严重的COVID-19病例中更高.
- 正如预期的那样,在停止服用ACE抑制剂时,ACE-S和 ангиотензин II (Ang II) 的水平增加.
结论:
- 在COVID-19的高血压患者中,RASi的延续似乎是安全的.
- 虽然ACE2水平没有差异,但RAS代谢物概况显示ACE抑制剂退出后预期的变化.
- 该研究强调,由于样本规模较小和RASi的频繁后期中止,需要进一步研究.
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