为什么不改变COVID-19患者高血压的治疗方法?血管紧张素转换酶2的双重作用

Pub Date : 2021-07-01 DOI:10.5603/AH.A2021.0014
T. Kosicka, J. Głuszek
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引用次数: 0

摘要

尽管做出了许多组织和医疗努力,但COVID-19疫情仍在继续,并造成了致命的伤亡。初步报告已经指出,患有包括高血压在内的合并症的人与该病相关的死亡率要高得多。SARS-CoV-2病毒通过受体进入人体血管紧张素转换酶2。血管紧张素转换酶抑制剂或沙坦类药物可增加这种酶的活性。因此,有人怀疑用这些制剂治疗的患者更容易感染,感染本身也更严重,与更高的死亡率相关。另一方面,已知ACE2酶可以降低肺损伤的风险。本文介绍了高血压患者中SARS-CoV-2病毒感染的频率、感染过程以及ACE抑制剂和沙坦类药物对这些患者死亡率的影响。目前的数据表明,在COVID-19患者中使用血管紧张素转换酶抑制剂和沙坦类药物不会使病程恶化,根据一些作者的说法,这种治疗甚至降低了这种感染的死亡率。
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Why not change the therapy of hypertension in patients with COVID-19. Dual role of angiotensin-converting enzyme 2
Despite many organizational and medical efforts, the COVID-19 epidemic continues and is taking a lethal toll. Preliminary reports have already reported that the mortality associated with this disease is much higher in people with comorbidities, including hypertension. SARS-CoV-2 virus enters the body through the receptor which is the angiotensin converting enzyme 2. The administration of angiotensin converting enzyme inhibitors or sartans increases the activity of this enzyme. Therefore, there was a suspicion that patients treated with these preparations become more easily infected, and the infection itself is more severe and is associated with greater mortality. On the other hand, the ACE2 enzyme is known to reduce the risk of lung damage. The paper presents current reports describing the frequency of SARS-CoV-2 virus infection in patients with hypertension, the course of infection and the effect of administration of ACE inhibitors and sartans on the mortality of these patients. The presented data indicate that the use of angiotensin converting enzyme inhibitors and sartans in patients with COVID-19 does not worsen the course of the disease, and according to some authors this treatment even reduces the mortality of this infection.
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