目的:分析中药联用血管紧张素受体拮抗剂(ARBs)治疗高血压病左心室肥厚(LVH)疗效与安全性。方法:计算机检索从建库至2019年12月31日PubMed、Cochrane Library、Embase、Web of Science、中国知网、维普、CBM、Wanfang Data数据库的文献...目的:分析中药联用血管紧张素受体拮抗剂(ARBs)治疗高血压病左心室肥厚(LVH)疗效与安全性。方法:计算机检索从建库至2019年12月31日PubMed、Cochrane Library、Embase、Web of Science、中国知网、维普、CBM、Wanfang Data数据库的文献,按照纳排标准选择文献并完成质量评价后,采用Rev Man 5.3软件进行系统评价。结果:最终纳入13个随机对照试验,共计1178例患者。结果显示:(1)逆转LVH方面:LVDd(P=0.13,WMD=-1.72,95%CI:-3.95~0.52);IVST(P=0.009,WMD=0.44,95%CI:0.11~0.77);LVPWT(P=0.0003,WMD=-0.91,95%CI:-1.40~-0.42);LVMI(P<0.0001,WMD=-8.16,95%CI:-11.97~-4.34);除LVDd外,各指标组间均具有统计学意义。(2)降压疗效:SBP(P=0.001,WMD=-6.40,95%CI:-10.35~-2.45);DBP(P=0.0007,WMD=-4.37,95%CI:-6.90~-1.84);SBP、DBP组间均具有统计学意义。(3)临床症状改善率:(P<0.00001,RR=1.21,95%CI:1.11~1.32),组间比较具有统计学意义。结论:该系统评价结果提示中药联用ARBs具有更好的逆转LVH和降压疗效,改善临床症状效果更佳。展开更多
Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) have been an arguable risk factor for COVID-19 diseases because they could upregulate Angiotensin Converting Enz...Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) have been an arguable risk factor for COVID-19 diseases because they could upregulate Angiotensin Converting Enzyme-2 (ACE2) expression, facilitating SARS-CoV2 entry to the lungs. Several retrospective clinical studies, however, found no such effect. Here, we explore how the use of ACEIs and ARBs links to COVID-19 across all countries of the world. Methods: Data on the availability of ACEIs and ARBs for 200 countries and on the number of cases and number of deaths per country by 28 December 2020 were extracted from WHO and Worldometer website, respectively. Data on life expectancy at age 65 years as a measure of ageing were from WHO and on Gross Domestic Product Per Capita (GDP PPP) and the percentage of urbanization were from the World Bank. Excel and SPSS v 26 software were used for statistical analyses. Results: In linear regression and logistic conditional regression analysis, GDP correlates with COVID-19 prevalence (rho = 0.66, p > 0.001) and deaths from COVID-19 (rho = 0.55, p < 0.001) while urbanization and life expectancy do not when GDP influence is controlled for. After statistically removing the effects of GDP on the prevalence and mortality from COVID-19, we found that countries without ACEI and ARB availability had lower COVID-19 cases and deaths (p < 0.02). Conclusions: Our study based on the global data contradicts findings of most published clinical studies at regional levels. We found that GDP positively correlates with prevalence of and mortality related to COVID-19. ACEI and ARB use increases COVID-19 infectivity and mortality.展开更多
文摘目的:分析中药联用血管紧张素受体拮抗剂(ARBs)治疗高血压病左心室肥厚(LVH)疗效与安全性。方法:计算机检索从建库至2019年12月31日PubMed、Cochrane Library、Embase、Web of Science、中国知网、维普、CBM、Wanfang Data数据库的文献,按照纳排标准选择文献并完成质量评价后,采用Rev Man 5.3软件进行系统评价。结果:最终纳入13个随机对照试验,共计1178例患者。结果显示:(1)逆转LVH方面:LVDd(P=0.13,WMD=-1.72,95%CI:-3.95~0.52);IVST(P=0.009,WMD=0.44,95%CI:0.11~0.77);LVPWT(P=0.0003,WMD=-0.91,95%CI:-1.40~-0.42);LVMI(P<0.0001,WMD=-8.16,95%CI:-11.97~-4.34);除LVDd外,各指标组间均具有统计学意义。(2)降压疗效:SBP(P=0.001,WMD=-6.40,95%CI:-10.35~-2.45);DBP(P=0.0007,WMD=-4.37,95%CI:-6.90~-1.84);SBP、DBP组间均具有统计学意义。(3)临床症状改善率:(P<0.00001,RR=1.21,95%CI:1.11~1.32),组间比较具有统计学意义。结论:该系统评价结果提示中药联用ARBs具有更好的逆转LVH和降压疗效,改善临床症状效果更佳。
文摘Background: Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) have been an arguable risk factor for COVID-19 diseases because they could upregulate Angiotensin Converting Enzyme-2 (ACE2) expression, facilitating SARS-CoV2 entry to the lungs. Several retrospective clinical studies, however, found no such effect. Here, we explore how the use of ACEIs and ARBs links to COVID-19 across all countries of the world. Methods: Data on the availability of ACEIs and ARBs for 200 countries and on the number of cases and number of deaths per country by 28 December 2020 were extracted from WHO and Worldometer website, respectively. Data on life expectancy at age 65 years as a measure of ageing were from WHO and on Gross Domestic Product Per Capita (GDP PPP) and the percentage of urbanization were from the World Bank. Excel and SPSS v 26 software were used for statistical analyses. Results: In linear regression and logistic conditional regression analysis, GDP correlates with COVID-19 prevalence (rho = 0.66, p > 0.001) and deaths from COVID-19 (rho = 0.55, p < 0.001) while urbanization and life expectancy do not when GDP influence is controlled for. After statistically removing the effects of GDP on the prevalence and mortality from COVID-19, we found that countries without ACEI and ARB availability had lower COVID-19 cases and deaths (p < 0.02). Conclusions: Our study based on the global data contradicts findings of most published clinical studies at regional levels. We found that GDP positively correlates with prevalence of and mortality related to COVID-19. ACEI and ARB use increases COVID-19 infectivity and mortality.
