在住院COVID-19患者中,宁-血管素系统激活和氧化应激:单中心前性观察性研究
Davide Eleuteri1,2, Filippo Del Tedesco1,2, Federico Silvia1,2
1Department of Intensive Care and Anesthesiology, Fondazione Policlinico Universitario A. Gemelli IRCCS, Rome, Italy.
Intensive care medicine experimental
|February 9, 2026
概括
COVID-19呼吸系统下降与氨酸-血管新生素系统 (RAS) 激活和内皮功能障碍相关. 监测RAS和不对称的二甲基氨基 (ADMA) 可以识别高风险患者.
科学领域:
- 心血管生物学 心血管生物学
- 传染病病理生理学 传染病病理生理学
- 翻译医学是一种翻译医学.
背景情况:
- 氨酸- ангиотензин系统 (RAS) 对血管健康和炎症至关重要.
- RAS失调与COVID-19的病原发生有关.
- 内皮功能障碍是严重的COVID-19的一个标志.
研究的目的:
- 在住院COVID-19患者中调查RAS和内皮功能障碍标记物的动态.
- 为了将这些生物标志物与呼吸道疾病进展相关联.
- 为了识别潜在的预测不良结果的预测因素.
主要方法:
- 对155名住院COVID-19患者进行前性观察研究.
- 在基线和第3天测量血雷宁, ангиотензин I (Ang I), ангиотензин II (Ang II), ангиотензин 1-7 (Ang 1-7), ангиотензин II/ ангиотензин I 的比率,以及不对称的二甲基氨基氨酸 (ADMA).
- 使用内皮激活和压力指数 (EASIX) 评估内皮损伤,并按呼吸轨迹分层.
主要成果:
- 呼吸状况恶化的患者表现为逐渐激活RAS,转向Ang1-7通路,ADMA和EASIX水平增加.
- 在第3天ADMA水平较高显著与呼吸系统恶化有关.
- 生物标志物轨迹根据疾病过程而异,基线ADMA独立预测了28天后更糟糕的预后.
结论:
- 恶化COVID-19呼吸状况与延迟RAS激活,转移到Ang 1-7通路,并发性内皮功能障碍有关.
- 对RAS和ADMA的连续测量可能有助于识别高危COVID-19患者.
- 这些生物标志物可以为COVID-19管理提供个性化的治疗策略.
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