沙库巴曲缬沙坦治疗维持性血液透析患者高血压的效果及其影响因素分析  

Analysis of the effect of sacubitril valsartan on hypertension in maintenance hemodialysis patients and its influencing factors

作　　者：陈小玲 贺霜 甘雅培 莫志宁 孙秀雯 CHEN Xiaoling;HE Shuang;GAN Yapei;MO Zhining;SUN Xiuwen(Hemodialysis Centre,Dongguan Qingxi Hospital,Dongguan 523000,China;Physical Examination Department,Dongguan Qingxi Hospital,Dongguan 523000,China;Rheumatology and Immunology Department,Dongguan Qingxi Hospital,Dongguan 523000,China)

机构地区：[1]东莞市清溪医院血透室,广东东莞523000 [2]东莞市清溪医院体检科,广东东莞523000 [3]东莞市清溪医院风湿免疫科,广东东莞523000

出　　处：《临床医学研究与实践》2024年第32期35-38,共4页Clinical Research and Practice

基　　金：2022年东莞市社会发展科技项目(2022年面上项目)(No.20221800900762)。

摘　　要：目的分析沙库巴曲缬沙坦(SV)治疗维持性血液透析(MHD)患者高血压的效果及其影响因素。方法选取2022年1月至2023年6月在东莞市清溪医院血液净化中心行MHD治疗的63例高血压患者为研究对象。所有患者均接受血管紧张素Ⅱ受体拮抗剂(ARB)治疗,治疗8周后改用SV治疗。比较患者SV治疗前、后的实验室指标、血压,分析超滤量与血压差值的关系。结果SV治疗前、后,患者的尿量、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血钾、白细胞计数(WBC)、血红蛋白(HB)、血小板计数(PLT)及脑钠肽(BNP)水平比较,差异无统计学意义(P>0.05)。SV治疗前、后,患者的透析前收缩压、透析前舒张压、透析间期收缩压、透析间期舒张压比较,差异具有统计学意义(P<0.05)。超滤量与透析前收缩压差值、透析前舒张压差值、透析间期收缩压差值、透析间期舒张压差值呈正相关(P<0.05)。多元线性回归分析结果显示,超滤量是透析前收缩压差值、透析前舒张压差值、透析间期收缩压差值及透析间期舒张压差值的独立影响因素(P<0.05)。结论SV能够有效降低MHD患者的血压,超滤量较高的患者降压效果更好。因此对于超滤量较大且血压控制率较差的患者,可优先考虑使用SV治疗。Objective To analyze the effect of sacubitril valsartan(SV)on hypertension in maintenance hemodialysis(MHD)patients and its influencing factors.Methods A total of 63 patients with hypertension who underwent MHD treatment in the blood purification center of Dongguan Qingxi Hospital from January 2022 to June 2023 were selected as the research objects.All patients were treated with angiotensin receptor blockade(ARB)and switched to SV treatment after 8 weeks of treatment.The laboratory indexes and blood pressure of patients before and after SV treatment were compared,and the relationship between ultrafiltration volume and blood pressure difference was analyzed.Results There were no significant differences in urine volume,alanine aminotransferase(ALT),aspartate aminotransferase(AST),serum potassium,white blood cell count(WBC),hemoglobin(HB),platelet count(PLT)and brain natriuretic peptide(BNP)before and after SV treatment(P>0.05).Before and after SV treatment,there were significant differences in pre-dialysis systolic blood pressure,pre-dialysis diastolic blood pressure,inter-dialysis systolic blood pressure and inter-dialysis diastolic blood pressure(P<0.05).Ultrafiltration volume was positively correlated with pre-dialysis systolic blood pressure difference,pre-dialysis diastolic blood pressure difference,inter-dialysis systolic blood pressure difference and inter-dialysis diastolic blood pressure difference(P<0.05).The results of multivariate linear regression analysis showed that ultrafiltration volume was an independent influencing factor of pre-dialysis systolic blood pressure difference,pre-dialysis diastolic blood pressure difference,inter-dialysis systolic blood pressure difference and inter-dialysis diastolic blood pressure difference(P<0.05).Conclusion SV can effectively reduce the blood pressure of MHD patients,and patients with higher ultrafiltration volume have better antihypertensive effect.Therefore,for patients with large ultrafiltration volume and poor blood pressure control rate,SV treatment can be

关 键 词：沙库巴曲缬沙坦 维持性血液透析 高血压 超滤量 血管紧张素Ⅱ受体拮抗剂 

分 类 号：R544.1[医药卫生—心血管疾病]