ACEI/ARB对新型冠状病毒肺炎合并高血压病人预后的影响  

Effect of ACEI/ARB on Patients with COVID-19 Complicated with Hypertension

作　　者：李超[1] 史宏涛[2] 韩清华[2] LI Chao;SHI Hongtao;HAN Qinghua(First Hospital of Shanxi Medical University,Taiyuan 030001,Shanxi,China)

机构地区：[1]山西医科大学第一临床医学院,太原030001 [2]山西医科大学第一医院,太原030001

出　　处：《中西医结合心脑血管病杂志》2023年第3期474-479,共6页Chinese Journal of Integrative Medicine on Cardio-Cerebrovascular Disease

基　　金：山西省教育厅高校科技创新计划基金资助项目,编号:晋教科〔2020〕3号。

摘　　要：目的:分析血管紧张素Ⅱ受体拮抗剂(ARB)/血管紧张素转换酶抑制剂(ACEI)类药物对新型冠状病毒肺炎(COVID-19)合并高血压病人各项临床指标及预后的影响,并探讨其临床应用价值。方法:选取2020年1月14日—2020年2月18日山西省各地区医院确诊COVID-19病人76例,根据是否合并高血压分为高血压组(21例)和非高血压组(55例);根据高血压病人是否长期服用ACEI/ARB类药物分为使用ACEI/ARB组(11例)和使用其他药物组(10例)。记录并比较病人相关病史及入院后一般生命体征、血常规、降钙素原(PCT)、C反应蛋白(CRP)、肝功能、肾功能、心肌损伤标志物等。比较病人出院后1个月、6个月、12个月的随访指标。结果:与非高血压组比较,高血压组病人年龄较大,体质指数(BMI)值较高,收缩压(SBP)、舒张压(DBP)增高,白细胞及中性粒细胞增多(P<0.05);使用其他药物组与使用ACEI/ARB组病人一般资料比较,差异均无统计学意义(P>0.05);使用ACEI/ARB组和使用其他药物组各指标随访结果比较,差异均无统计学意义(P>0.05)。结论:ACEI/ARB类药物并未对COVID-19合并高血压病人各项临床指标产生明显影响,且不影响该类病人的预后,可以考虑继续服用ACEI/ARB进行临床治疗。Objective:To analyze the effects of angiotensinⅡreceptor antagonists(ARB)/angiotensin converting enzyme inhibitors(ACEI)on clinical indicators and prognosis of patients with corona virus disease 2019(COVID-19)complicated with hypertension,and to explore the clinical application value.Methods:A total of 76 COVID-19 patients confirmed in hospitals in Shanxi Province from January 14,2020 to February 18,2020 were selected and divided into hypertensive group(n=21)and non-hypertensive group(n=55)according to whether they were complicated with hypertension.Patients with hypertension were divided into ACEI/ARB group(n=11)and other drug group(n=10)according to whether they took ACEI/ARB drugs for a long time.The relevant medical history,general vital signs,blood routine,procalcitonin(PCT),C-reactive protein(CRP),liver and kidney function,myocardial injury markers were recorded and compared.Follow-up indexes at 1,6 and 12 months after discharge were compared.Results:Compared with the non-hypertensive group,patients in the hypertensive group were older,with higher body mass index,systolic blood pressure,diastolic blood pressure,and leukocytes and neutrophils(P<0.05).There was no significant difference in general data,follow-up results between other drug group and the ACEI/ARB group(P>0.05).Conclusion:ACEI/ARB drugs do not significantly affect various clinical indicators in patients with COVID-19 complicated with hypertension,and do not affect the prognosis of patients,so the results suggest that ACEI/ARB can be used for hypertension treatment in patients with COVID-19.

关 键 词：高血压 新型冠状病毒肺炎 COVID-19 血管紧张素转换酶抑制剂 血管紧张素Ⅱ受体拮抗剂 

分 类 号：R544.1[医药卫生—心血管疾病] R511[医药卫生—内科学]