沙库巴曲缬沙坦联合马来酸左旋氨氯地平治疗原发性高血压伴稳定型心绞痛的效果  

The effect of sacubitril valsartan combined with levamlodipine maleate in the treatment of essential hypertension with stable angina pectoris

作　　者：李学英 魏江 李甜甜 董静 马鹏超[1] LI Xue-ying;WEI Jiang;LI Tian-tian;DONG Jing;MA Peng-chao(Department of Cardiovascular Disease,The First Division Hospital of Xinjiang Production and Construction Corps,Aksu 843000,China)

机构地区：[1]新疆生产建设兵团第一师医院心血管病科,新疆维吾尔自治区阿克苏市843000

出　　处：《中国心血管病研究》2024年第3期255-260,共6页Chinese Journal of Cardiovascular Research

基　　金：新疆维吾尔自治区自然科学基金(2021D01C603)。

摘　　要：目的探讨沙库巴曲缬沙坦联合马来酸左旋氨氯地平治疗原发性高血压伴稳定型心绞痛(EH+SAP)的效果。方法选取2021年5月~2023年4月新疆生产建设兵团第一师医院EH+SAP患者128例,采用随机数字表法分为两组,各64例。两组均给予常规治疗,对照组采用奥美沙坦联合马来酸左旋氨氯地平治疗,观察组采用沙库巴曲缬沙坦联合马来酸左旋氨氯地平治疗。两组均连续治疗8周后进行疗效评估。比较两组治疗前、治疗8周血压、心绞痛情况、硝酸甘油用量变化,并检测中性粒细胞/高密度脂蛋白胆固醇比值(NHR)、心血管调节肽(salusin-β)水平。分析治疗8周NHR、salusin-β与血压、心绞痛情况、硝酸甘油用量的关系。统计两组治疗期间不良反应发生率。结果观察组治疗总有效率高于对照组[92.19%(59/64)比78.13%(50/64),P<0.05];治疗8周后两组24 h平均收缩压(24 h SBP)[(124.26±8.58)mmHg比(129.15±9.04)mm Hg]、24 h平均舒张压(24 h DBP)[(84.46±6.21)mmHg比(88.12±6.77)mmHg]、收缩压变异性(SBPV)[(9.54±2.42)mmHg比(10.63±2.30)mmHg]、舒张压变异性(DBPV)[(7.59±1.54)mmHg比(8.32±1.43)mmHg]、心绞痛发作次数[(0.33±0.10)次/周比(0.44±0.13)次/周]、心绞痛持续时间[(2.73±0.61)min比(3.42±0.98)min]、硝酸甘油用量[(0.17±0.05)mg/周比(0.23±0.06)mg/周]、NHR[(4.32±0.89)比(4.79±0.93)]、salusin-β[(3.65±0.57)nmol/L比(3.96±0.55)nmol/L]降低,且观察组低于对照组(P均<0.05);两组治疗8周NHR、salusin-β与24 h SBP、24 h DBP、SBPV、DBPV、心绞痛发作次数、心绞痛持续时间、硝酸甘油使用量均呈正相关(P<0.05);治疗期间两组水肿、头晕、潮红、心悸、低血压发生率比较,差异无统计学意义(P>0.05)。结论沙库巴曲缬沙坦联合马来酸左旋氨氯地平对EH+SAP疗效显著,可有效控制患者血压,减轻心绞痛症状,可能与调节NHR、salusin-β水平变化有关,且安全性有保障。Objective To investigate the effect of sacubitril valsartan combined with levamlodipine maleate in the treatment of essential hypertension with stable angina pectoris(EH+SAP).Methods A total of 128 patie nts with EH+SAP in the First Division Hospital of Xinjiang Production and Construction Corps from May 2021 to April 2023 were selected and divided into two groups with 64 cases in each group by random number table method.Both groups were given conventional treatment,the control group was treated with olmesartan combined with levamlodipine maleate,and the observation group was treated with sacubactril valsartan combined with levamlodipine maleate.The efficacy of both groups was evaluated after continuous treatment for 8 weeks.Blood pressure,angina pectoris and nitroglycerin dosage were compared between the two groups before treatment and 8 weeks after treatment,and NHR and salusin-βlevels were detected.The relationship between NHR,salusin-βand blood pressure,angina pectoris and nitroglycerin dosage were analyzed.The incidence of adverse reactions during treatment was analyzed.Results The total effective rate of observation group was higher than that of control group[92.19%(59/64)vs.78.13%(50/64),P<0.05].After 8 weeks of treatment,24 h mean systolic blood pressure(24 h SBP)[(124.26±8.58)mmHg vs.(129.15±9.04)mmHg],24 h mean diastolic blood pressure(24 h DBP)[(84.46±6.21)mmHg vs.(88.12±6.77)mmHg],systolic blood pressure variability(SBPV)[(9.54±2.42)mmHg vs.(10.63±2.30)mmHg],diastolic blood pressure variability(DBPV)[(7.59±1.54)mmHg vs.(8.32±1.43)mmHg],angina pectoris frequency[(0.33±0.10)times/week vs.(0.44±0.13)times/week],angina pectoris duration[(2.73±0.61)min vs.(3.42±0.98)min],nitroglycerin dosage[(0.17±0.05)mg/week vs.(0.23±0.06)mg/week],NHR[(4.32±0.89)vs.(4.79±0.93)],salusin-β[(3.65±0.57)nmol/L vs.(3.96±0.55)nmol/L]decreased in both groups,and the observation group were lower than the control group(all P<0.05).After 8 weeks of treatment,NHR and salusin-βwere positively correlated with 24

关 键 词：沙库巴曲缬沙坦 马来酸左旋氨氯地平 高血压 心绞痛 中性粒细胞 高密度脂蛋白胆固醇 心血管调节肽 

分 类 号：R544.1[医药卫生—心血管疾病]