血管紧张素转换酶抑制剂/血管紧张素受体拮抗剂在新型冠状病毒肺炎疫情防控中的应用分析

Application of angiotensin-converting enzyme inhibitor/angiotensin receptor antagonist during COVID-19 epidemic prevention and control

根据《中国心血管病报告》,中国现患心血管病人数约2.9亿,而大量循证医学证据证实了血管紧张素转换酶抑制剂(ACEI)或血管紧张素受体拮抗剂(ARB)治疗心血管等疾病的价值。ACEI/ARB是肾素-血管紧张素-醛固酮系统(RAAS)的阻滞剂,可上调血管紧张素转换酶2(ACE2)表达水平。而ACE2是新型冠状病毒肺炎(COVID-19)发生发展的关键分子靶点,一方面它是侵入人体细胞的必须受体,触发了COVID-19的发生,另一方面在COVID-19的发展过程中发挥抗炎保护作用。本文探讨在疫情防控期间能否使用ACEI/ARB,以期为心血管疾病患者合理使用ACEI/ARB提供思路与参考。

According to the Chinese Cardiovascular Disease Report,there are about 290 million people with cardiovascular diseases in China,and a large amount of evidence-based medical evidence has shown the value of angiotensin-converting enzyme inhibitor(ACEI)or angiotensin receptor antagonist(ARB)in the treatment of cardiovascular diseases.ACEI/ARB is a blocking agent of renin-angiotensin-aldosterone system(RAAS),which can up-regulate the expression level of angiotensin-converting enzyme 2(ACE2).ACE2 is a key molecular target for the development of Corona Virus Disease 2019(COVID-19).On the one hand,ACE2 is an essential receptor for the invasion of human cells,triggering the development of COVID-19,and on the other hand,it plays an anti-inflammatory protective role in the development of COVID-19.In this paper,we discuss whether ACEI/ARB can be used during COVID-19 epidemic prevention and control,so as to provide ideas and references for the rational use of ACEI/ARB in patients with cardiovascular diseases.