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高血压患者严重急性呼吸综合征冠状病毒2型的易感性和血管紧张素转换酶抑制剂用药探讨

  • 顾可羿1 ,
  • 汪慧菁1 ,
  • 赵超2 ,
  • 3
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  • 1. 上海健康医学院基础医学院神经精神药理学实验室,上海 201318;  2. 复旦大学上海医学院基础医学院教育部、卫健委、医科院医学分子病毒学重点实验室,上海 200032;  3. 复旦大学附属华山医院国家老年疾病临床医学研究中心,上海 200041

收稿日期: 2020-03-01

  网络出版日期: 2020-10-25

基金资助

“十三五”国家重点研发计划(2018YFC2002000/03)

Potential impact of hypertension and angiotensin converting enzyme inhibitors treatment on severe acute respiratory syndrome coronavirus 2 susceptibility and prognosis

  • GU Keyi1 ,
  • WANG Huijing1 ,
  • ZHAO Chao2 ,
  • 3
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  • 1. Laboratory of Neuropsychopharmacology, School of Fundamental medicine, Shanghai University of Medicine & Health Sciences, Shanghai 201318, China;  2. MOE/NHC/CAMS Key Laboratory of Molecular Virology, School of Basic Medical Sciences, Shanghai Medical College, Fudan university, Shanghai 200032, China;  3. National Clinical Research Center on Aging and Medicine, Huashan Hospital, Shanghai 200041, China

Received date: 2020-03-01

  Online published: 2020-10-25

摘要

严重急性呼吸综合征冠状病毒2型(severe acute respiratory syndrome coronavirus 2,SARS-CoV-2)引起的2019冠状病毒病(coronavirus disease 2019,COVID-19)呈现出两个高比例态势,一是病毒感染者合并高血压比例较高;二是合并高血压的病毒感染者发展为重症和危重病例的比例高。这提示病毒感染与高血压之间存在密切联系,因此对高血压患者这一特殊群体的合理用药提出了需求。本文通过分析血管紧张素转换酶 2(angiotensin converting enzyme 2,ACE2),即SARS-CoV-2的功能性受体与ACE之间的平衡关系,探讨高血压与病毒易感性之间的联系,以及高血压人群罹患COVID-19可能的发病规律。由于高血压群体中,血管紧张素转换酶抑制剂(angiotensin converting enzyme inhibitors, ACEI)的应用占有重要地位,本文从药理学和病原学角度进行分析,对该人群病毒感染前后的高血压用药给出指导建议,以供临床参考。

本文引用格式

顾可羿1 , 汪慧菁1 , 赵超2 , 3 . 高血压患者严重急性呼吸综合征冠状病毒2型的易感性和血管紧张素转换酶抑制剂用药探讨[J]. 微生物与感染, 2020 , 15(5) : 316 -321 . DOI: 10.3969/j.issn.1673-6184.2020.05.008

Abstract

Two subgroups of coronavirus disease 2019(COVID-19) patients deserved special medical attention, one being hypertension patients, the other being hypertension patients treated with angiotensin converting enzyme inhibitors (ACEI). Relatively high susceptibility of hypertension patients to the disease and severe prognosis for the ones using ACEI indicate that there is a close relationship between virus infection and hypertension, which puts forward the demand for rational medication for the special group of patients with hypertension. In this paper, we analyzed the balance between angiotensin converting enzyme 2 (ACE2), the functional receptor of SARS-CoV-2, and ACE, and then discussed the relationship between hypertension and virus susceptibility, as well as the possible pathogenesis of COVID-19 in hypertension. Because the angiotensin converting enzyme inhibitors (ACEI) play an important role in the population of hypertension, we give guidance and suggestions on the medication of hypertension before and after virus infection in this population for clinical reference in this paper by the analysis of pharmacology and etiology.
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