摘要
背景:腹主动脉瘤(AAA)是指腹主动脉的局限性扩张。AAA主要是无症状的,但动脉瘤破裂导致死亡率高,直径大于55 mm的AAA具有很高的破裂风险,目前尚无有效的限制小型AAA生长的药物治疗。 目的:综述抑制AAA生长的现状和面临的挑战。 方法:总结人体研究和动物模型研究的数据,特别是在临床网站上搜索与AAA生长有关的正在进行或已完成的研究的细节,检索关键词“腹主动脉瘤”和“药物”,找出延缓或阻止AAA生长的潜在靶点。 结果:这些临床试验涉及许多挑战,包括演示试验的设计、尽量减少参与者的放弃试验率,以及在试验期间进行准确的结果评估。许多临床试验集中在药物干预(如血管紧张素转换酶抑制剂、β-阻滞剂、他汀类和抗生素)上,这些干预对AAA患者延缓或逆转动脉瘤扩张以及推迟选择性手术修复的终点都是有效的。 结论:需要进一步的随机、对照、临床试验,以制定有效的非手术治疗AAA。
关键词: 腹主动脉瘤,发病机制,药物干预,临床试验,强力霉素,阿托伐他汀,替米沙坦。
图形摘要
Current Drug Targets
Title:Current Theories and Clinical Trial Evidence for Limiting Human Abdominal Aortic Aneurysm Growth
Volume: 19 Issue: 11
关键词: 腹主动脉瘤,发病机制,药物干预,临床试验,强力霉素,阿托伐他汀,替米沙坦。
摘要: Background: Abdominal aortic aneurysm (AAA) refers to localized dilation of abdominal aorta. AAA is largely asymptomatic, but aneurysmal rupture results in a high mortality rate. AAA with a diameter greater than 55 mm carries a high risk of rupture. There are currently no known medical treatments effective in limiting the growth of small AAA.
Objective: To review the current status of and challenges faced in limiting AAA growth.
Methods: Data from human investigations and animal model studies were summarized. In particular, the ClinicalTrials.gov website was searched for details of ongoing or completed studies related to AAA growth. We searched the key words ‘abdominal aortic aneurysm’ and ‘drugs’ to identify potential target drugs for slowing or stopping AAA growth.
Results: These clinical trials involve a number of challenges, including demonstrating the design of the trial, minimizing the participant dropout rate, and developing accurate outcome assessments during the trials. A number of clinical trials have concentrated on pharmaceutical intervention (such as angiotensin- converting enzyme inhibitors, beta-blockers, statins, and antibiotics) that could be effective for AAA patients in delaying or reversing aneurysm expansion and postponing the endpoint for elective surgical repair.
Conclusions: Further randomized, controlled, clinical trials are required to develop effective nonsurgical therapies for AAA.
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Cite this article as:
Current Theories and Clinical Trial Evidence for Limiting Human Abdominal Aortic Aneurysm Growth, Current Drug Targets 2018; 19 (11) . https://dx.doi.org/10.2174/1389450118666171113114310
DOI https://dx.doi.org/10.2174/1389450118666171113114310 |
Print ISSN 1389-4501 |
Publisher Name Bentham Science Publisher |
Online ISSN 1873-5592 |
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