摘要
目的 系统评价血管紧张素转换酶抑制剂(ACEI)和血管紧张素受体拮抗剂(ARB)类药物对中国新型冠状病毒肺炎(COVID-19)患者预后的影响。方法 计算机检索PubMed、EMbase、Web of Science、The Cochrane Library、CNKI、WanFang Data和VIP数据库,搜集ACEI/ARB类药物对中国COVID-19患者预后影响的队列研究,检索时限均为2020年1月至2022年1月。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用Rev Man 5.3软件进行Meta分析。结果 共纳入17个队列研究,包括4 912例患者。Meta分析结果显示,使用ACEI/ARB类药物患者比未使用患者的住院时间更短[SMD=-0.28,95%CI(-0.46,-0.11),P=0.002],死亡率更低[OR=0.47,95%CI(0.36,0.62),P<0.000 01]。结论 当前有限证据显示,使用ACEI/ARB类药物可在一定程度上改善中国COVID-19患者的临床预后。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。
Objective To systematically review the impact of ACEI/ARB(angiotensin converting enzyme inhibitor/angiotensin receptor antagonist) treatment on the clinical outcomes of Chinese patients with COVID-19 infections. Methods Pub Med, EMbase, Web of Science, The Cochrane Library, CNKI, Wan Fang Data, and VIP databases were electronically searched to collect cohort studies on the impact of the treatment with ACEI/ARB on the clinical outcomes of Chinese patients with COVID-19 infections from January 2020 to January 2022. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Then, meta-analysis was performed using Rev Man 5.3 software. Results A total of 17 cohort studies involving 4 912 subjects were included.The results of meta-analysis showed that patients who were prescribed ACEI/ARB had shorter hospital stays(SMD=-0.28,95%CI-0.46 to-0.11, P=0.002) and a lower mortality rate(OR=0.47, 95%CI 0.36 to 0.62, P<0.000 01) than patients who did not take ACEI/ARB. Conclusion Current evidence shows that the use of ACEI/ARB drugs can improve the clinical prognosis of Chinese patients with COVID-19 infections. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
作者
黄徐瑞
袁琪
王宁夫
周亮
叶显华
黄进宇
HUANG Xurui;YUAN Qi;WANG Ningfu;ZHOU Liang;YE Xianhua;HUANG Jinyu(Department of Cardiology,Affiliated Hangzhou First People's Hospital,Zhejiang University School of Medicine,Hangzhou 310000,P.R.China;Institute of Mental Health in Singapore,999002,Singapore)
出处
《中国循证医学杂志》
CSCD
北大核心
2022年第4期438-443,共6页
Chinese Journal of Evidence-based Medicine
