坦度螺酮联合沙库巴曲缬沙坦治疗原发性高血压伴焦虑患者的疗效及机制  

Efficacy and mechanism of tandospirone combined with sacubitril valsartan in the treatment of patients with essential hypertension and concomitant anxiety

作　　者：郭晓平 袁艳敏[1] GUO Xiaoping;YUAN Yanmin(The Second Department of Cardiology,Cangzhou Hospital of Integrated TCM-WM·Hebei,Cangzhou 061000,Hebei,China)

机构地区：[1]河北省沧州中西医结合医院心内二科,河北省沧州市061000

出　　处：《广西医学》2023年第5期516-522,共7页Guangxi Medical Journal

基　　金：河北省沧州市科学技术研究与发展指导计划项目(162302207)。

摘　　要：目的探讨坦度螺酮联合沙库巴曲缬沙坦治疗原发性高血压(EH)伴焦虑患者的临床疗效,以及其对患者血管内皮功能和血清同型半胱氨酸(Hcy)、核苷酸结合寡聚化结构域样受体蛋白3(NLRP3)、白细胞介素-1β(IL-1β)水平的影响。方法选择160例EH伴焦虑患者作为研究对象,按照随机数字表法分为两组(各80例)。观察组给予坦度螺酮和沙库巴曲缬沙坦治疗,对照组单用沙库巴曲缬沙坦治疗。连续治疗8周后观察两组临床疗效及不良反应发生情况。治疗前后对两组患者进行24 h动态血压监测,焦虑程度评估,血管内皮功能指标[内皮素1、一氧化氮、血管性血友病因子(vWF)]检测,以及血清Hcy、NLRP3、IL-1β水平检测。结果治疗后,两组白昼平均收缩压、白昼平均舒张压、夜间平均收缩压、夜间平均舒张压、24 h平均收缩压、24 h平均舒张压均较治疗前下降,而杓型节律占比较治疗前增高,且观察组上述指标均优于对照组(均P<0.05)。治疗后,两组焦虑自评量表评分、汉密尔顿焦虑量表评分较治疗前降低,血清内皮素1、vWF、Hcy、NLRP3和IL-1β水平较治疗前下降,血清一氧化氮水平较治疗前升高,且观察组上述评分及血清学指标均优于对照组(均P<0.05)。两组不良反应总发生率比较差异无统计学意义(P>0.05)。结论坦度螺酮联合沙库巴曲缬沙坦不仅可安全有效地控制EH伴焦虑患者的血压,还可缓解患者的焦虑情绪,且效果优于单用沙库巴曲缬沙坦,其作用机制可能与更有效地调节血清Hcy、NLRP3、IL-1β水平及血管内皮功能有关。Objective To explore the clinical efficacy of tandospirone combined with sacubitril valsartan in the treatment of patients with essential hypertension(EH)and concomitant anxiety,and its influences on vascular endothelial function and the levels of serum homocysteine(Hcy),nucleotide-binding oligomerization domain-like receptor protein 3(NLRP3),interleukin-1β(IL-1β).Methods A total of 160 patients with EH and concomitant anxiety were selected as the research subjects,and they were divided into two groups according to the random number table method,with 80 cases in each group.The observation group was administrated tandospirone and sacubitril valsartan,and the control group was treated with sacubitril valsartan alone.The clinical efficacy and the occurrence of adverse reactions 8 weeks after continuous treatment were observed in both groups.The pre-and post-treatment 24-hour dynamic blood pressure monitoring,anxiety degree evaluation,and detection of vascular endothelial function indices with respect to endothelin 1,nitric oxide,von Willebrand factor(vWF),as well as detection of serum Hcy,NLRP3,IL-1βlevels were performed on patients in both groups.Results After treatment,daytime mean systolic blood pressure,daytime mean diastolic blood pressure,night mean systolic blood pressure,night mean diastolic blood pressure,24-hour mean systolic blood pressure and 24-hour mean diastolic blood pressure were decreased in both groups as compared with before treatment,and the proportion of arytenoid rhythm was increased in both groups as compared with before treatment,as well as the aforementioned indices were superior in the observation group to in the control group(all P<0.05).After treatment,scores of Self-Rating Anxiety Scale and Hamilton Anxiety Scale of both groups were decreased as compared with before treatment,and the levels of serum endothelin 1,vWF,Hcy,NLRP3,and IL-1βof both groups were decreased,whereas serum nitric oxide level of both groups was elevated as compared with before treatment,as well as the scores and

关 键 词：原发性高血压 焦虑 坦度螺酮 沙库巴曲缬沙坦 血管内皮功能 炎症反应 

分 类 号：R544.1[医药卫生—心血管疾病] R[医药卫生—内科学]