ACEI类降压药物可能增加术后恶心呕吐风险

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　　术后恶心呕吐（PONV）是术后常见的并发症，PONV不仅降低病人满意度，甚至还可能导致一些严重的不良事件，
如误吸、伤口裂开和食管撕裂等。成人PONV的发生率在20-40%，对于某些高危病人，甚至高达79%。
　　ACEI类药物是常用的降压药物，虽在围手术期的应用存在一定争议，但仍是广泛使用的降压药物。
　　ACEI的使用为何会增加PONV的风险呢？本人新近发表的一篇论文详尽阐述了这个问题---
        Xiong C, Wang LT, An DJ, et al. Perioperative use of centrally actingangiotensin-converting enzyme inhibitor may increase patients. Med Hypotheses2016, 86:1-2. (IF=1.074)
       所以，对于使用ACEI的患者，是否应该更加注重PONV的预防呢？

论文摘要
Substance P (SP) is involved in the development of postoperative nausea and vomiting (PONV). It ishydrolyzed by angiotensin-converting enzyme (ACE). Centrally acting ACE inhibitors (CACE-Is) are widelyused in the perioperative period. The current evidence showed CACE-Is could upregulate SP level in thecentral nervous system which may contribute to the occurrence of PONV in 0–72 h. Here, we present ourhypothesis that the use of CACE-Is in the perioperative period may increase patients’ risk for both early(0–24 h) and late (24–72 h) PONV. The identification of this new risk factor may improve patients’ riskassessment and thus lead to better prophylaxis strategies for PONV that are base on risk stratification.

全文在附件。