摘要
目的探讨沙库巴曲缬沙坦(angiotensin-receptor neprilysin inhibitors,ARNI)治疗老年高血压(hypertension,HTN)的效果。方法选取2020年2月至2023年2月宜春市中医院收治的104例老年HTN患者作为研究对象,根据治疗用药的不同分为对照组与观察组,每组52例。对照组采用替米沙坦治疗,观察组采用ARNI治疗,比较两组血压控制情况、心功能指标、肝肾功能指标及不良反应发生情况。结果治疗后,两组24 h平均收缩压、24 h平均舒张压、24 h收缩压负荷、24 h舒张压负荷、24 h舒张压变异性及观察组24 h收缩压变异性(24 h systolic blood pressure variability,24 h SBPV)均低于治疗前,且观察组低于对照组,差异有统计学意义(P<0.05),对照组治疗前后24 h SBPV比较差异无统计学意义。治疗后,两组左心室射血分数(left ventricular ejection fraction,LVEF)均高于治疗前,N末端B型钠尿肽原(N-terminal pro-B-type natriuretic peptide,NT-proBNP)水平均低于治疗前,且观察组左心室后壁厚度(left ventricular posterior wall thickness,LVPWT)薄于治疗前,左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)短于治疗前,NT-proBNP水平低于对照组,差异有统计学意义(P<0.05);两组间治疗后LVEF、LVPWT、LVEDD及对照组组内治疗前后LVPWT、LVEDD比较差异均无统计学意义。治疗后,两组谷丙转氨酶(alanine aminotransferase,ALT)水平均高于治疗前,差异有统计学意义(P<0.05),两组内治疗前后血肌酐(serum creatinine,SCr)、血尿酸(blood uric acid,BUA)、血钾(serum potassium,K)水平比较差异无统计学意义;两组组间治疗前后SCr、ALT、BUA、K水平比较差异均无统计学意义;观察组不良反应发生率为5.76%,对照组为3.84%,两组间比较差异无统计学意义。结论ARNI治疗老年HTN能改善其血压控制情况及心功能,且不会增加肝肾损伤及不良反应,值得临床推广应用。
Objective To investigate the effect of angiotensin-receptor neprilysin inhibitors(ARNI)in the treatment of senile hypertension(HTN).Methods 104 senile HTN patients admitted to Yichun Hospital of Traditional Chinese Medicine from February 2020 to February 2023 were selected as the study subjects,and they were divided into the control group and the observation group according to the different therapeutic drugs,with 52 cases in each group.The control group was treated with telmisartan,and the observation group was treated with ARNI,the blood prsessure control,cardiac function index,liver and kidney function index and the occurrence of adverse reactions were compared between the two groups.Results After treatment,the 24 h mean systolic blood pressure,24 h mean diastolic blood pressure,24 h systolic blood pressure load,24 h diastolic blood pressure load,24 h diastolic blood pressure variability of the two groups and the 24 h systolic blood pressure variability(24 h SBPV)in the observation group were lower than those before treatment,and the observation group was lower than the control group,and the differences were statistically significant(P<0.05),there was no significant difference in SBPV at 24 h before and after treatment in control group.After treatment,the left ventricular ejection fraction(LVEF)of the two groups were higher than that before treatment,N-terminal pro-B-type natriuretic peptide(NTproBNP)levels were lower than that before treatment,and the left ventricular posterior wall thickness(LVPWT),left ventricular end-diastolic diameter(LVEDD)in the observation group were shorter than before treatment,and NT-proBNP level was lower than that in the control group,and the differences were statistically significant(P<0.05);there were no significant differences in LVEF,LVPWT and LVEDD between the two groups after treatment and the LVPWT and LVEDD before and after treatment in the control group.After treatment,the level of alanine aminotransferase(ALT)of the two groups were higher than that before treatment,and the difference was statistically significant(P<0.05),there were no significant differences in the serum creatinine(SCr),blood uric acid(BUA)and blood potassium(K)levels before and after treatment between the two groups;there were no significant differences in SCr,ALT,BUA and K levels before and after treatment between the two groups.The incidence of adverse reactions in the observation group was 5.76%,and the control group was 3.84%,and there was no significant difference between the two groups.Conclusion ARNI in the treatment of senile HTN can improve the control of blood pressure control and cardiac function,and does not increase liver and kidney damage and adverse reactions,which is worthy of clinical promotion and application.
作者
周富平
袁尚红
曾微微
ZHOU Fuping;YUAN Shanghong;ZENG Weiwei(Department of General Medicine,Yichun Hospital of Traditional Chinese Medicine,Yichun,Jiangxi,336000,China;Xiujiang Community Service Center,Yichun Hospital of Traditional Chinese Medicine,Yichun,Jiangxi,336000,China)
出处
《当代医学》
2024年第34期46-50,共5页
Contemporary Medicine
基金
宜春市科技计划项目(JXYC2021KSA061)。
关键词
沙库巴曲缬沙坦
老年高血压
替米沙坦
心功能
Angiotensin-receptor neprilysin inhibitors
Senile hypertension
Telmisartan
Cardiac function
