目的了解中国中西部城市急性心肌梗死(AMI)患者血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体阻滞剂(ACEI/ARB)的使用情况,并探讨其影响因素。方法采用两阶段随机抽样抽取中西部城市31家医院2001年、2006年、2011年的AMI患者病历,收集和提...目的了解中国中西部城市急性心肌梗死(AMI)患者血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体阻滞剂(ACEI/ARB)的使用情况,并探讨其影响因素。方法采用两阶段随机抽样抽取中西部城市31家医院2001年、2006年、2011年的AMI患者病历,收集和提取相关资料,分析ACEI/ARB的使用情况以及使用的影响因素。结果共入选3044例患者,其中中国指南Ⅰ类推荐2951例,指南Ⅱa类推荐93例。2001年、2006年和2011年,指南Ⅰ类推荐患者ACEI/ARB使用情况为240(71.43%)、598(73.19%)、1230(68.41%);指南Ⅱa类推荐患者为4(57.14%)、5(62.50%)和37(47.44%)。在3个研究年份中,ACEI使用率均显著高于ARB(71.13%vs.0.60%;71.36%vs.2.57%;57.23%vs.11.79%),差异有统计学意义(P均<0.05)。多因素分析显示,与对应组相比,合并高血压(OR=2.37,95%CI:1.89~2.98)、糖尿病(OR=1.32,95%CI:1.02~1.70),心力衰竭病史(OR=1.65,95%CI:1.29~2.12),年龄≥75岁(OR=1.49,95%CI:1.14~1.95),入院时收缩压≥140 mm Hg(OR=1.94,95%CI:1.55~2.43),肾小球滤过率未测量(OR=4.10,95%CI:2.66~6.33)的患者更倾向于使用ACEI/ARB。女性(OR=0.77,95%CI:0.63~0.94)、非前壁ST段抬高型心肌梗死(OR=0.69,95%CI:0.59~0.82)、左室射血分数未测量(OR=0.47,95%CI:0.36~0.61)、有中风史(OR=0.73,95%CI:0.57~0.95)、合并慢性肾功能不全(OR=0.44,95%CI:0.20~0.95)的患者较少使用ACEI/ARB。结论中西部城市AMI患者中,指南I类推荐的患者约1/3住院期间未接受ACEI/ARB类药物治疗,且10年间该类药物的应用无明显改善。基于指南强烈推荐,AMI患者需增加ACEI/ARB类药物的应用。展开更多
目的观察雷公藤多苷片治疗IgA肾病蛋白尿的临床疗效及安全性。方法选取2016年10月—2019年9月期间就诊于中国中医科学院西苑医院门诊的IgA肾病患者62例,按照是否接受雷公藤多苷片治疗分为观察组和对照组,每组各31例。对照组给予常规剂...目的观察雷公藤多苷片治疗IgA肾病蛋白尿的临床疗效及安全性。方法选取2016年10月—2019年9月期间就诊于中国中医科学院西苑医院门诊的IgA肾病患者62例,按照是否接受雷公藤多苷片治疗分为观察组和对照组,每组各31例。对照组给予常规剂量的血管紧张素转化酶抑制剂(Angiotensin-Converting Enzyme Inhibitor,ACEI)或血管紧张素受体拮抗剂(Angiotensin II Receptor Blocker,ARB)治疗,观察组在常规ACEI/ARB治疗的基础上加用雷公藤多苷片。治疗3个月后,观察比较两组患者治疗前后24 h尿蛋白定量(24 h U-TP)、肾功能指标[血肌酐(Serum Creatinine,Scr)、GFR]、肝功能指标[谷丙转氨酶(Alanine Aminotransferase,ALT)、谷草转氨酶(Aspartate Aminotransferase,AST)]、血常规指标[白细胞(White Blood Cells,WBC)、血红蛋白(Hemoglobin,HGB)、血小板(Platelet,PLT)]及临床疗效。结果治疗后对照组Scr较治疗前降低,GFR较治疗前升高,差异有统计学意义(P<0.05);观察组患者24 h U-TP、Scr均较治疗前明显降低,GFR较治疗前升高,差异有统计学意义(P<0.05);且观察组24 h U-TP治疗前后差值改善明显优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者ALT、AST指标与治疗前比较,差异无统计学意义(P>0.05)。治疗后两组患者WBC、HGB、PLT水平与治疗前比较,差异无统计学意义(P>0.05)。治疗后观察组总有效率83.87%(26/31)明显高于对照组总有效率54.84%(17/31),差异有统计学意义(P<0.05)。治疗期间两组患者均未发生骨髓抑制。结论雷公藤多苷片联合ACEI/ARB,可安全有效降低IgA肾病患者蛋白尿水平,改善患者肾功能。展开更多
A database of 38 tripeptides with C-terminal proline was constructed to study QSAR of ACE inhibitory peptides. The model was established using PLS based on the three z-scores of 20 coded amino acids. The prediction ab...A database of 38 tripeptides with C-terminal proline was constructed to study QSAR of ACE inhibitory peptides. The model was established using PLS based on the three z-scores of 20 coded amino acids. The prediction ability of tripeptides model was improved with proline as terminal. The coefficient of determination(R2) and the cross validated coefficient(Q2LOO) of the model are 0.856 and 0.782 respectively. According to the model, two potential ACE inhibitory tripeptides IIP and IVP were synthesized. Their IC50(inhibitor concentration that reduced enzyme activity by 50%) were proved to be 1.58 and 1.39 μM respectively by direct spectrophotometric measurement, and they are very close to the predicted value by the model.展开更多
The ACE （angiotensin converting enzyme） inhibitors are not only drugs widely prescribed drugs in cardiovascular diseases, but also potentially therapeutic agents in dementia. Based on the findings that the ACE inhib...The ACE （angiotensin converting enzyme） inhibitors are not only drugs widely prescribed drugs in cardiovascular diseases, but also potentially therapeutic agents in dementia. Based on the findings that the ACE inhibitors could activate the c-Jun N-terminal kinase signal to increase the ACE gene expression and that the Alu element of the human ACE gene involved in regulating ACE promoter activity, we aimed to investigate whether there are different pharmacogenetic responses of ACE I/D polymorphism to the ACE inhibitors in neurons. The three reporter vectors, pACEpro（0-SEAP, p-I-ACEpro-SEAP, and p-D-ACEpro-SEAP were used to examine the transcriptional activity of the vectors responding to the lisinopril treatment using a transient-transfection method in SH-SY5Y cells. Our results showed that lisinopril increased the promoter activity of an ACE gene by 16.7%. Additionally, we found the lisinopril enhanced the ACE promoter activity of the I-form vector by 17.2%, but adversely reduced that of the D-form vector by 16.8%, as compared with the respective control without the lisinopril treatment. Firstly, our findings had proved that the UD polymorphism of ACE gene contrarily responds to the ACE inhibitors in regulating the ACE expression in neurons, which provide a novel insight suggesting genetic testing to tailor the treatment regimens in AD （Alzheimer＇s disease） patients.展开更多
<strong>Background: </strong>Angiotensin-converting enzyme inhibitors (ACEIs) and angiotensin-II receptor blockers (ARBs) have been an arguable risk factor for COVID-19 diseases because they could upregula...<strong>Background: </strong>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.<strong> Methods:</strong> 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.<strong> Results:</strong> 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). <strong>Conclusions:</strong> 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
With the wide spread of COVID-19,some studies have confirmed that novel coronavirus enters the cell through the binding of spike protein and ACE2 protein,which has the risk of causing the virus to enter the cell to ac...With the wide spread of COVID-19,some studies have confirmed that novel coronavirus enters the cell through the binding of spike protein and ACE2 protein,which has the risk of causing the virus to enter the cell to accelerate its transmission.ACEI and ARB are the key drugs for the treatment of hypertension and are widely used in clinic.They are good for ventricular and vascular remodeling in patients with hypertension,coronary heart disease and heart failure.ACEI and ARB drugs may increase the expression of ACE2 in lung tissue and increase the risk of aggravation of the disease.According to the advice of hypertension experts:for mild ordinary COVID-19 patients with hypertension,we can consider discontinuing ACEI and ARB drugs,while for severe COVID-19 patients with hypertension,ACEI and ARB drugs should be stopped immediately.During the discontinuation period,temporary replacement therapy with diuretics,dipine and vasodilatation hypotensive drugs can be considered.展开更多
文摘目的了解中国中西部城市急性心肌梗死(AMI)患者血管紧张素转化酶抑制剂/血管紧张素Ⅱ受体阻滞剂(ACEI/ARB)的使用情况,并探讨其影响因素。方法采用两阶段随机抽样抽取中西部城市31家医院2001年、2006年、2011年的AMI患者病历,收集和提取相关资料,分析ACEI/ARB的使用情况以及使用的影响因素。结果共入选3044例患者,其中中国指南Ⅰ类推荐2951例,指南Ⅱa类推荐93例。2001年、2006年和2011年,指南Ⅰ类推荐患者ACEI/ARB使用情况为240(71.43%)、598(73.19%)、1230(68.41%);指南Ⅱa类推荐患者为4(57.14%)、5(62.50%)和37(47.44%)。在3个研究年份中,ACEI使用率均显著高于ARB(71.13%vs.0.60%;71.36%vs.2.57%;57.23%vs.11.79%),差异有统计学意义(P均<0.05)。多因素分析显示,与对应组相比,合并高血压(OR=2.37,95%CI:1.89~2.98)、糖尿病(OR=1.32,95%CI:1.02~1.70),心力衰竭病史(OR=1.65,95%CI:1.29~2.12),年龄≥75岁(OR=1.49,95%CI:1.14~1.95),入院时收缩压≥140 mm Hg(OR=1.94,95%CI:1.55~2.43),肾小球滤过率未测量(OR=4.10,95%CI:2.66~6.33)的患者更倾向于使用ACEI/ARB。女性(OR=0.77,95%CI:0.63~0.94)、非前壁ST段抬高型心肌梗死(OR=0.69,95%CI:0.59~0.82)、左室射血分数未测量(OR=0.47,95%CI:0.36~0.61)、有中风史(OR=0.73,95%CI:0.57~0.95)、合并慢性肾功能不全(OR=0.44,95%CI:0.20~0.95)的患者较少使用ACEI/ARB。结论中西部城市AMI患者中,指南I类推荐的患者约1/3住院期间未接受ACEI/ARB类药物治疗,且10年间该类药物的应用无明显改善。基于指南强烈推荐,AMI患者需增加ACEI/ARB类药物的应用。
文摘目的观察雷公藤多苷片治疗IgA肾病蛋白尿的临床疗效及安全性。方法选取2016年10月—2019年9月期间就诊于中国中医科学院西苑医院门诊的IgA肾病患者62例,按照是否接受雷公藤多苷片治疗分为观察组和对照组,每组各31例。对照组给予常规剂量的血管紧张素转化酶抑制剂(Angiotensin-Converting Enzyme Inhibitor,ACEI)或血管紧张素受体拮抗剂(Angiotensin II Receptor Blocker,ARB)治疗,观察组在常规ACEI/ARB治疗的基础上加用雷公藤多苷片。治疗3个月后,观察比较两组患者治疗前后24 h尿蛋白定量(24 h U-TP)、肾功能指标[血肌酐(Serum Creatinine,Scr)、GFR]、肝功能指标[谷丙转氨酶(Alanine Aminotransferase,ALT)、谷草转氨酶(Aspartate Aminotransferase,AST)]、血常规指标[白细胞(White Blood Cells,WBC)、血红蛋白(Hemoglobin,HGB)、血小板(Platelet,PLT)]及临床疗效。结果治疗后对照组Scr较治疗前降低,GFR较治疗前升高,差异有统计学意义(P<0.05);观察组患者24 h U-TP、Scr均较治疗前明显降低,GFR较治疗前升高,差异有统计学意义(P<0.05);且观察组24 h U-TP治疗前后差值改善明显优于对照组,差异有统计学意义(P<0.05)。治疗后两组患者ALT、AST指标与治疗前比较,差异无统计学意义(P>0.05)。治疗后两组患者WBC、HGB、PLT水平与治疗前比较,差异无统计学意义(P>0.05)。治疗后观察组总有效率83.87%(26/31)明显高于对照组总有效率54.84%(17/31),差异有统计学意义(P<0.05)。治疗期间两组患者均未发生骨髓抑制。结论雷公藤多苷片联合ACEI/ARB,可安全有效降低IgA肾病患者蛋白尿水平,改善患者肾功能。
基金Supported by the National Natural Science Foundation of China(No,20903026)the Talents Introduction Foundation for Universities of Guangdong Province(2011)the Science and Technology planning Project of Guangzhou(No.2013J4100071)
文摘A database of 38 tripeptides with C-terminal proline was constructed to study QSAR of ACE inhibitory peptides. The model was established using PLS based on the three z-scores of 20 coded amino acids. The prediction ability of tripeptides model was improved with proline as terminal. The coefficient of determination(R2) and the cross validated coefficient(Q2LOO) of the model are 0.856 and 0.782 respectively. According to the model, two potential ACE inhibitory tripeptides IIP and IVP were synthesized. Their IC50(inhibitor concentration that reduced enzyme activity by 50%) were proved to be 1.58 and 1.39 μM respectively by direct spectrophotometric measurement, and they are very close to the predicted value by the model.
文摘The ACE （angiotensin converting enzyme） inhibitors are not only drugs widely prescribed drugs in cardiovascular diseases, but also potentially therapeutic agents in dementia. Based on the findings that the ACE inhibitors could activate the c-Jun N-terminal kinase signal to increase the ACE gene expression and that the Alu element of the human ACE gene involved in regulating ACE promoter activity, we aimed to investigate whether there are different pharmacogenetic responses of ACE I/D polymorphism to the ACE inhibitors in neurons. The three reporter vectors, pACEpro（0-SEAP, p-I-ACEpro-SEAP, and p-D-ACEpro-SEAP were used to examine the transcriptional activity of the vectors responding to the lisinopril treatment using a transient-transfection method in SH-SY5Y cells. Our results showed that lisinopril increased the promoter activity of an ACE gene by 16.7%. Additionally, we found the lisinopril enhanced the ACE promoter activity of the I-form vector by 17.2%, but adversely reduced that of the D-form vector by 16.8%, as compared with the respective control without the lisinopril treatment. Firstly, our findings had proved that the UD polymorphism of ACE gene contrarily responds to the ACE inhibitors in regulating the ACE expression in neurons, which provide a novel insight suggesting genetic testing to tailor the treatment regimens in AD （Alzheimer＇s disease） patients.
文摘<strong>Background: </strong>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.<strong> Methods:</strong> 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.<strong> Results:</strong> 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). <strong>Conclusions:</strong> 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.
基金The Third Session of National TCM Master Project of the National Administration of Traditional Chinese Medicine/National Famous TCM Doctor Inheritance Studio Construction Project(GuoZhong YiYaoBanRenJiaoHan2018119)。
文摘With the wide spread of COVID-19,some studies have confirmed that novel coronavirus enters the cell through the binding of spike protein and ACE2 protein,which has the risk of causing the virus to enter the cell to accelerate its transmission.ACEI and ARB are the key drugs for the treatment of hypertension and are widely used in clinic.They are good for ventricular and vascular remodeling in patients with hypertension,coronary heart disease and heart failure.ACEI and ARB drugs may increase the expression of ACE2 in lung tissue and increase the risk of aggravation of the disease.According to the advice of hypertension experts:for mild ordinary COVID-19 patients with hypertension,we can consider discontinuing ACEI and ARB drugs,while for severe COVID-19 patients with hypertension,ACEI and ARB drugs should be stopped immediately.During the discontinuation period,temporary replacement therapy with diuretics,dipine and vasodilatation hypotensive drugs can be considered.
