沙库巴曲缬沙坦与缬沙坦治疗慢性心功能不全的疗效比较及对患者外周血单个核细胞锌指蛋白A20和核因子-κB的影响  

The efficacy comparison of sakubatril valsartan and valsartan in the treatment of patients with chronic cardiac insufficiency and the influence on zinc finger protein A20 and nuclear factor-κB in peripheral blood mononuclear cells

作　　者：赵鲁静 李传方[1] 张苒[1] 张艳青 Zhao Lujing;Li Chuanfang;Zhang Ran;Zhang Yanqing(Department of Cardiology,Affiliated Hospital of Jining Medical College,Jining 272000,China)

机构地区：[1]济宁医学院附属医院心内四科,济宁272000

出　　处：《中国医师进修杂志》2022年第12期1088-1092,共5页Chinese Journal of Postgraduates of Medicine

摘　　要：目的比较沙库巴曲缬沙坦与缬沙坦治疗慢性心功能不全患者的效果及对患者外周血单个核细胞(PBMCs)锌指蛋白A20和核因子-κB(NF-κB)的影响。方法连续入选2019年2月至2020年1月济宁医学院附属医院收治的慢性心功能不全患者97例,按随机数字表法分为对照组(48例)和观察组(49例),两组均接受常规抗心力衰竭治疗,对照组加用缬沙坦胶囊,观察组加用沙库巴曲缬沙坦治疗,比较两组治疗前、治疗后3个月心功能指标的变化和超敏C反应蛋白(hs-CRP)、肿瘤坏死因子-α(TNF-α)、基质金属蛋白酶9(MMP-9)、N末端脑钠肽前体(NT-proBNP)的变化;并提取PBMCs,检测锌指蛋白A20、NF-κB水平;统计两组不良反应发生情况,分析锌指蛋白A20、NF-κB与心肌损伤标志物NT-proBNP的相关性。结果治疗后3个月,观察组心功能指标改善情况优于对照组,并且观察组hs-CRP、TNF-α、MMP-9、NT-proBNP水平低于对照组[(1.96±0.57)mg/L比(2.87±0.79)mg/L、(7.11±1.46)μg/L比(8.24±1.57)μg/L、(110.14±10.63)μg/L比(129.52±17.96)μg/L、(716.91±105.78)ng/L比(965.25±97.41)ng/L],差异有统计学意义(P<0.05)。治疗后3个月,观察组锌指蛋白A20、NF-κB水平低于对照组[(3.57±1.13)%比(4.41±1.32)%、(29.87±6.58)ng/L比(35.71±10.02)ng/L],差异有统计学意义(P<0.05)。慢性心功能不全患者A20、NF-κB与心肌损伤标志物NT-proBNP均呈正相关(r=0.487、0.738,P<0.01)。结论在常规治疗基础上加用沙库巴曲缬沙坦较缬沙坦更能提高慢性心功能不全患者心功能,减轻机体炎性反应,降低心肌损伤标志物NT-proBNP表达,抑制PBMCs NF-κB活化,降低锌指蛋白A20水平。Objective To compare the efficacy of sakubatril valsartan and valsartan in the treatment of patients with chronic cardiac insufficiency and the influence on zinc finger protein A20 and nuclear factor-κB(NF-κB)in peripheral bloodmononuclear cells(PBMCs).Methods Ninety-senven patients with chronic cardiac insufficiency admitted to the Affiliated Hospital of Jining Medical College from February 2019 to January 2020 were continuously selected and randomly divided into the control group(48 cases)and the observation group(49 cases).Both groups received routine anti-heart failure according to the guidelines.The control group added with valsartan and the observation group added with sakubatril valsartan treatment.Before the treatment and after 3 months of treatment,the changes of cardiac function indexes and the changes of inflammatory markers such as hypersensitive C-reactive protein(hs-CRP),tumor necrosis factor-α(TNF-α),matrix metalloproteinase 9(MMP-9),and N-terminal pro B-type natriuretic peptide(NT-proBNP)were compared.PBMCs was extracted to detect zinc finger protein A20 and NF-κB levels.The incidence of adverse reactions in the two groups was recorded,and the relationship between zinc finger proteins A20,NF-κB and the myocardial injury marker NT-proBNP were analyzed.Results After 3 months of treatment,the changes of cardiac function indexes in the observation group were better than those in the control group and the levels of hs-CRP,TNF-α,MMP-9,NT-proBNP in the observation group were lower than those in the control group:(1.96±0.57)mg/L vs.(2.87±0.79)mg/L,(7.11±1.46)μg/L vs.(8.24±1.57)μg/L,(110.14±10.63)μg/L vs.(129.52±17.96)μg/L,(716.91±105.78)ng/L vs.(965.25±97.41)ng/L,there were statistical differences(P<0.05).After 3 months of treatment,the levels of finger protein A20,NF-κB in the observation group were lower than those in the control group:(3.57±1.13)%vs.(4.41±1.32)%,(29.87±6.58)ng/L vs.(35.71±10.02)ng/L,there were statistical differences(P<0.05).Finger protein A20 and NF-κB in pati

关 键 词：心力衰竭 沙库巴曲缬沙坦 缬沙坦 锌指蛋白A20 核因子-ΚB 

分 类 号：R541.6[医药卫生—心血管疾病]