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find Keyword "血管紧张素转换酶抑制剂" 10 results
  • Effects of ACEI in Stroke Treatment and Prevention

    Angiotensin converting enzyme inhibitor (ACEI) is an important type of antihypertensive drug. Much evidence shows that ACEI not only decreases the blood pressure but also has the protective effect on the cardiac and cerebral vessels. ACEI may prevent the stroke. To provide the best evidence for the clinical practice, we electronically searched RCTs and systematic reviews from MEDLINE and The Cochrane Library to evaluate the mechanisms and the effects of ACEI in stroke treatment and prevention.

    Release date:2016-08-25 03:34 Export PDF Favorites Scan
  • 血管紧张素转换酶抑制剂与β受体阻滞剂对心瓣膜置换术后心脏结构及功能的影响

    目的 探讨血管紧张素转换酶抑制剂(ACEI)和β-受体阻滞剂对心瓣膜置换术后患者心脏结构和功能的影响。 方法 选择2009年4~10月南华大学附属第一医院心瓣膜病患者60例,男28例,女32例;年龄19~66岁(46.25±11.59岁)。风湿性病变52例,先天性心脏病3例,退行性病变5例。行二尖瓣置换术37例,主动脉瓣置换术15例,二尖瓣和主动脉瓣双瓣膜置换术8例。根据术后给予的辅助药物不同将60例患者分为3组,每组20例。A组:术后给予强心、利尿药治疗;B组:术后给予强心、利尿药和ACEI治疗;C组:术后给予强心、利尿药、ACEI和β-受体阻滞剂治疗。分别于心瓣膜手术术前、术后2周、8周和16周检测3组患者的超声心动图指标。 结果 术后2周3组右心室舒张期末内径(RVEDD)和左心室短轴缩短率(LVFS)较术前有所下降(Plt;0.05)。A组术后8周和16周左心房内径(LAD)和RVEDD与术后2周差异无统计学意义(Pgt;0.05),而LVFS较术后2周有所提高(Plt;0.05)。B组和C组术后8周和16周LAD和RVEDD呈进行性下降,而LVFS呈进行性升高(Plt;0.05),与术前比较均明显增高(Plt;0.05);且C组LVFS改善程度优于B组(Plt;0.05)。 结论 心瓣膜病患者行人工机械瓣置换术后给予常规强心、利尿治疗外,辅以ACEI和/或β-受体阻滞剂治疗可能更有助于改善心脏功能和结构。ACEI+β-受体阻滞剂联合使用较单独使用ACEI对心瓣膜置换术后患者心功能的恢复更有帮助。

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • 血管紧张素转换酶抑制剂对心肌再灌注损伤的作用

    心肌再灌注损伤可表现为再灌注性心律失常、心肌顿抑和心肌坏死.研究表明心脏局部的肾素血管紧张素系统和冠状动脉内皮细胞功能失常在心肌再灌注损伤中起重要作用.血管紧张素转换酶抑制剂能抑制转换酶活性,减少血管紧张素Ⅱ的形成,并能作用于激肽酶Ⅱ,抑制缓激肽的降解,后者可促进前列环素和一氧化氮(NO)的产生.近年来血管紧张素转换酶抑制剂被用于防护心肌再灌注损伤,在防护再灌注性心律失常、心肌顿抑和心肌坏死等方面显示了较好的治疗效果.

    Release date:2016-08-30 06:35 Export PDF Favorites Scan
  • Angiotensin Receptor Blockers versus Angiotensin-Converting Enzyme Inhibitors for Coronary Heart Disease: A Meta-Analysis

    Objective To compare the effectiveness and safety of angiotensin receptor blockers (ARB) and angiotensin-converting enzyme inhibitors (ACEI) for coronary heart disease (CHD). Methods Randomized controlled trials (RCTs) on ARB vs. ACEI in treating CHD were collected in databases including MEDLINE, EMbase, BIOSIS Previews, The Cochrane Library, CBM, VIP, WanFang Data and CNKI from inception to July 2011, and the references of the included articles were also retrieved. In accordance with the Cochrane Handbook 5.0.1, two reviewers independently evaluated the quality of articles, and extracted and cross-checked the data. Then meta-analysis was performed using RevMan 5.1.1 software. Results A total of 18 RCTs (17 660 cases) were included. The results of meta-analysis showed that there were no significant differences between the ARB group and the ACEI group in all-cause mortality (RR=1.04, 95%CI 0.98 to 1.11, P=0.20), cardiovascular mortality (RR=1.04, 95%CI 0.97 to 1.12, P=0.26), myocardial infarction (RR=0.98, 95%CI 0.92 to 1.05, P=0.59), hospitalization for heart failure (RR=1.14, 95%CI 0.97 to 1.32, P=0.11) and stroke (RR=0.93, 95%CI 0.80 to 1.08, P=0.34). However, the risk of adverse events causing drug discontinuation was significantly lower in the ARB group compared with the ACEI group (RR=0.77, 95%CI 0.67 to 0.89, P=0.000 3). Conclusion Current evidence suggests that ARB is as effective as ACEI in reducing the risk of all-cause mortality, cardiovascular mortality, myocardial infarction, hospitalization for heart failure and stroke in patients with coronary heart disease. Moreover, it is much better in tolerance. Because of the quality limitation and sampling size of the induced studies, this conclusion still needs to be further proved by more large-scale, multicenter and perspective clinical trials.

    Release date:2016-09-07 10:58 Export PDF Favorites Scan
  • Effects of Calcium Channel Blockers and Angiotensin Converting Enzyme Inhibitors on the Left Ventricular Hypertrophy in Chinese Hypertensive Patients: A Systematic Review

    Objective To systematically evaluate the effectiveness and safety of calcium channel blockers (CCBs) and angiotensin-converting enzyme inhibitors (ACEIs) used alone v.s. used in combination on the reversion of left ventricular hypertrophy (LVH) in Chinese essential hypertension (EH) patients. Methods The following databases were searched, including, Cochrane Library (Issue 7, 2011), PubMed (1980 to 2011), EMbase (1990 to 2011), CBM (1978 to 2011), CNKI (1994 to 2011), VIP (1989 to 2011), and WanFang Data (1998 to 2011). The studies were screened, and the quality was evaluated according to predefined inclusion and exclusion criteria, and then Meta-analysis was conducted by using RevMan 5.1 software. Results A total of 10 studies involving 859 patients were included. The results of Meta-analysis showed that the CCBs plus ACEIs group (the combination group) was superior to the CCBs group in improving EH patients’ systolic pressure (SBP) (MD= –6.49, 95%CI –10.55 to –2.43), diastolic pressure (DBP) (MD= –4.48, 95%CI –6.76 to –2.21), left ventricular mass index (LVMI) (MD= –5.31, 95%CI –8.43 to –2.19), interventricular septal thickness (IVST) (MD= –1.33, 95%CI –2.00 to –0.66) and left ventricular posterior wall thickness (LVPWT) (MD= –0.87, 95%CI –1.41 to –0.33). In addition, compared with the ACEIs group, the combination group was greatly superior in decreasing LVMI (MD= –11.54, 95%CI –15.06 to –8.01), IVST (MD= –0.76, 95%CI –1.25 to –0.27) and LVPWT (MD= –0.80, 95%CI –1.01 to –0.59). But clinical effectiveness was similar between the combination group and the CCBs group or the ACEIs group in aspects of the left ventricular end diastolic diameter (LVEDD), fraction shortening (FS) and ejection fractions (EF) (Pgt;0.05). Conclusion The combination therapy of CCBs with ACEIs is superior to either the CCBs or the ACEIsmonothrepy in regression of left ventricular hypertrophy. Because of the low methodological quality and small sample, this conclusion needs to be proved by more high-quality, large-scale and multicenter randomized controlled trials in the future.

    Release date:2016-09-07 10:59 Export PDF Favorites Scan
  • Amlodipine and Angiotensin-Converting Enzyme Inhibitor Combination versus Amlodipine Monotherapy in Adult Primary Hypertension: A Meta-Analysis of Randomized Controlled Trials

    Objective To estimate the efficacy and tolerability of combination of Amlodipine and different angiotensin-converting enzyme inhibitors (ACEIs) in comparison with Amlodipine monotherapy in the treatment of hypertension. Methods We searched the Cochrane Central Register of Controlled Trials (Issue 2, 2009), PubMed, MEDLINE, EMbase, CBM, and CNKI (from their inception to August 2009) for relevant studies. Two reviewers independently retrieved randomized controlled trials (RCTs) according to the inclusion and exclusion criteria, assessed the methodological quality of included trials, and extracted data. Meta-analysis was performed by Stata 10.0 soft. Results Seventeen RCTs involving 3 291 patients were ultimately identified. The results of meta-analyses showed combination had a greater systolic blood pressure reduction (WMD=5.72, 95%CI 4.10 to 7.33, P=0.016) and diastolic blood pressure reduction (WMD=3.62, 95%CI 4.85 to 2.39, P=0.000) than monotherapy. Combination had fewer overall adverse events (RR=0.86, 95% CI 0.75 to 0.99) than that of monotherapy. Conclusion The results of meta-analyses indicate that combination provides a superior blood pressure control to that of monotherapy and has fewer adverse events and better tolerability in hypertensive patients.

    Release date:2016-09-07 11:23 Export PDF Favorites Scan
  • New Advance of Evidence-based Research of Hypertension in 2004

    We correct some misunderstandings of hypertension therapy and update the knowledge of hypertensive drugs by reviewing the progress of evidence-based research of hypertension in 2004.

    Release date:2016-09-07 02:25 Export PDF Favorites Scan
  • Evidence-based Prevention and Treatment of Microalbuminuria in Patient with Type 2 Diabetes

    Objective To search evidence of angiotensin-converting-enzyme inhibitors for microalbumin-uria in type 2 diabetes for guiding clinical practice. Methods We searched MEDLINE ( 1970 -Jun. 2005 ) to identify randomized controlled trials (RCT)of the effect on angiotensin-converting-enzyme inhibitors to prevent microalbuminuria in type 2 diabetes. Results One RCT (n =1 204)was identified. The result showed that angiotensin-converting-enzyme inhibitors were significantly more effective in prevention of microalbuminuria than other medicines in type 2 diabetes. However, angiotensin-converting-enzyme inhibitors may increase the risk of cardiac mortality. We explained the evidence to patients and they were satisfied with our explanation. Conclusions Angiotensin-converting-enzyme inhibitors can decrease the incidence of microalbuminuria in patients with type 2 diabetes and hypertension.

    Release date:2016-09-07 02:26 Export PDF Favorites Scan
  • 微量白蛋白尿在原发性高血压患者中的临床意义

    微量白蛋白尿是指尿中白蛋白排泄率超过正常范围,受血压水平、血糖、血脂、体重等诸多因素的影响,是高血压早期肾脏损害的标志,也是全身血管内皮细胞受损的重要标志之一。微量白蛋白尿具有重要意义,是高血压患者心血管疾病的独立危险因子。原发性高血压患者应进行微量白蛋白尿筛查。

    Release date:2016-09-08 09:11 Export PDF Favorites Scan
  • Efficacy of different renin-angiotensin system blockers in patients with prior stroke: a network meta-analysis

    ObjectivesTo systematically review the efficacy of different rennin-angiotensin system blockers in prevention of stroke recurrence and reduction of major vascular events in patients with prior stroke.MethodsPubMed, The Cochrane Library, EMbase, CNKI, CBM and VIP databases were electronically searched to collect randomized controlled trials (RCTs) on the efficacy of ACEIs and ARBs for stroke secondary prevention from inception to November 1st, 2018. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies. Network meta-analysis was then performed by using Stata 15.1 software.ResultsA total of 6 RCTs involving 25 620 patients were included. The results of network meta-analysis showed that: in prevention of stroke recurrence, candesartan (RR=0.40, 95%CI 0.16 to 0.99) and valsartan (RR=0.22, 95%CI 0.07 to 0.76) were significantly lower than placebo; valsartan was lower than telmisartan (RR=0.24, 95%CI 0.07 to 0.81), ramipril (RR=0.26, 95%CI 0.07 to 0.93) and perindopril (RR=0.23, 95%CI 0.07 to 0.81). For reducing the major vascular events after stroke, candesartan (RR=0.39, 95%CI 0.21 to 0.74), valsartan (RR=0.27, 95%CI 0.11 to 0.64) and ramipril (RR=0.76, 95%CI 0.60 to 0.95) were significantly lower than placebo; valsartan was lower than telmisartan (RR=0.29, 95%CI 0.12 to 0.69), ramipril (RR=0.36, 95%CI 0.15 to 0.88) and perindopril (RR=0.28, 95%CI 0.12 to 0.68); candesartan was lower than telmisartan (RR=0.42, 95%CI 0.22 to 0.79) and perindopril (RR=0.41, 95%CI 0.21 to 0.79).ConclusionsCurrent evidence shows that valsartan and candesartan can reduce the stroke recurrence and major vascular events after stroke. Ramipril can reduce the major vascular event in patients with prior stroke. Valsartan might be the best option in both outcomes. Due to limited quantity of the included studies, more high quality studies are required to verify above conclusions.

    Release date:2019-11-19 10:03 Export PDF Favorites Scan
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