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首页> 外文期刊>Acute and critical care. >Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study
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Effect of Renin-Angiotensin System Blockage in Patients with Acute Respiratory Distress Syndrome: A Retrospective Case Control Study

机译：肾素-血管紧张素系统阻滞在急性呼吸窘迫综合征患者中的作用：一项回顾性病例对照研究

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Background Acute respiratory distress syndrome (ARDS) remains a life-threatening disease. Many patients with ARDS do not recover fully, and progress to terminal lung fibrosis. Angiotensin-converting enzyme (ACE) inhibitor is known to modulate the neurohormonal system to reduce inflammation and to prevent tissue fibrosis. However, the role of ACE inhibitor in the lungs is not well understood. We therefore conducted this study to elucidate the effect of renin-angiotensin system (RAS) blockage on the prognosis of patients with ARDS. Methods We analyzed medical records of patients who were admitted to the medical intensive care unit (ICU) at a tertiary care hospital from January 2005 to December 2010. ARDS was determined using the Berlin definition. The primary outcome was the mortality rate of ICU. Survival analysis was performed after adjustment using propensity score matching. Results A total of 182 patients were included in the study. Thirty-seven patients (20.3%) took ACE inhibitor or angiotensin receptor blocker (ARB) during ICU admission, and 145 (79.7%) did not; both groups showed similar severity scores. In the ICU, mortality was 45.9% in the RAS inhibitor group and 58.6% in the non-RAS inhibitor group (P = 0.166). The RAS inhibitor group required a longer duration of mechanical ventilation (29.5 vs. 19.5, P = 0.013) and longer ICU stay (32.1 vs. 20.2 days, P 0.001). In survival analysis, the RAS inhibitor group showed better survival rates than the non-RAS group (P 0.001). Conclusions ACE inhibitor or ARB may have beneficial effect on ARDS patients.
机译：背景技术急性呼吸窘迫综合征（ARDS）仍然是威胁生命的疾病。许多ARDS患者不能完全康复，并发展为终末肺纤维化。已知血管紧张素转换酶（ACE）抑制剂可调节神经激素系统以减少炎症并防止组织纤维化。但是，ACE抑制剂在肺中的作用尚不清楚。因此，我们进行了这项研究，以阐明肾素-血管紧张素系统（RAS）阻滞对ARDS患者预后的影响。方法我们分析了2005年1月至2010年12月在三级医院住院的重症监护病房（ICU）的患者的病历。使用柏林定义确定了ARDS。主要结果是ICU的死亡率。调整后使用倾向评分匹配进行生存分析。结果本研究共纳入182例患者。三十七名患者（占20.3％）在ICU入院期间服用ACE抑制剂或血管紧张素受体阻滞剂（ARB），而145名患者（占79.7％）未服用。两组的严重程度得分相似。在ICU中，RAS抑制剂组的死亡率为45.9％，非RAS抑制剂组的死亡率为58.6％（P = 0.166）。 RAS抑制剂组需要更长的机械通气时间（29.5 vs. 19.5，P = 0.013）和更长的ICU停留时间（32.1 vs. 20.2天，P <0.001）。在生存分析中，RAS抑制剂组的生存率要高于非RAS组（P <0.001）。结论ACE抑制剂或ARB可能对ARDS患者有益。

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