文章摘要
骆蓓蓓,李胜开.沙库巴曲 /缬沙坦在维持性血液透析高血压 65例中的应用[J].安徽医药,2023,27(6):1263-1268.
沙库巴曲 /缬沙坦在维持性血液透析高血压 65例中的应用
Application of sacubitril/valsartan in maintenance hemodialysis hypertension in 65 cases
  
DOI:10.3969/j.issn.1009-6469.2023.06.047
中文关键词: 沙库巴曲 /缬沙坦  维持性血液透析  高血压  心力衰竭  C反应蛋白质
英文关键词: Sacubitril/valsartan  Maintenance hemodialysis  Hypertension  Heart failure  C-reactive protein
基金项目:
作者单位E-mail
骆蓓蓓 徐州医科大学附属医院肾内科江苏徐州 221000  
李胜开 徐州医科大学附属医院肾内科江苏徐州 221000 lsk2869388@126.com 
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中文摘要:
      目的探讨沙库巴曲 /缬沙坦(SV)治疗维持性血液透析(MHD)高血压病人的疗效及安全性。方法回顾性分析 2020年 1月至 2021年9月徐州医科大学附属医院血液净化中心 MHD合并高血压病人的病历资料,其中服用 SV降压 65例(观察组)服用缬沙坦降压 65例(对照组)。对比治疗前、治疗 1周、 4周、 12周透析前后血压情况,同时分析治疗前及治疗 12周心脏彩超参数、血,常规、血生化变化情况以及不良反应事件发生情况。结果观察组治疗 1周后透析后收缩压较治疗前下降,治疗 4周后透析前和透析后收缩压分别较治疗前及治疗 1周下降,治疗 12周透析前收缩压、透析前舒张压、透析后收缩压、透析后舒张压分别较治疗前下降,治疗 12周观察组病人透析前舒张压、透析后收缩压及透析后舒张压均低于对照组[(78.20±9.23)mmHg比(81.66±7.83)mmHg、(144.43± 9.15)mmHg比(154.72±9.62)mmHg、(77.45±8.76)mmHg比(81.98±7.85)mmHg](P<0.05);观察组中合并射血分数降低的心力衰竭(HFrEF)和射血分数中间值的心力衰竭(HFmrEF)病人治疗 12周左心射血分数(LVEF)均较治疗前提高, N末端前 B型利钠肽、左室舒张末期内径均较治疗前下降,其中 LVEF与对照组相比差异有统计学意义(P<0.05);观察组治疗前超敏 C反应蛋白高于对照组,治疗 12周低于对照组(P<0.05);两组病人治疗前及治疗 12周血红蛋白、白蛋白、血清钾、血肌酐组间比较均差异无统计学意义(P>
英文摘要:
      Objective To investigate the efficacy and safety of sacubitril/valsartan (SV) in the treatment of maintenance hemodialysis (MHD) patients with hypertension.Methods The clinical records of patients with MHD complicated with hypertension in the bloodpurification center of the Affiliated Hospital of Xuzhou Medical University from January 2020 to November 2021 were retrospectivelyanalyzed, including 65 cases with SV for blood pressure lowering (observation group) and 65 cases with valsartan for blood pressure lowering (control group). The blood pressure before and after dialysis before treatment and at 1 week, 4 weeks and 12 weeks of treatmentwere compared, and the cardiac ultrasound parameters, routine blood tests, blood biochemical changes and the occurrence of adversereactions before and after 12 weeks of treatment were also analyzed.Results The systolic blood pressure (SBP) after hemodialysis inthe observation group decreased after 1 week of treatment compared with that before treatment. After 4 weeks of treatment, the SBP before hemodialysis and after hemodialysis decreased compared with those before treatment and 1 week of treatment, respectively. After12 weeks of treatment, SBP before hemodialysis, diastolic blood pressure (DBP) before hemodialysis, SBP after hemodialysis, and DBPafter hemodialysis decreased compared with those before treatment. DBP before hemodialysis and SBP and DBP after hemodialysiswere lower in the observation group than in the control group at 12 weeks of treatment [(78.20±9.23) mmHg vs. (81.66±7.83) mmHg, (144.43±9.15) mmHg vs.(154.72±9.62) mmHg, (77.45±8.76) mmHg vs. (81.98±7.85) mmHg] (P<0.05). After 12 weeks of treatment, theleft heart ejection fraction (LVEF) of MHD patients complicated with heart failure with reduced ejection fraction (HFrEF) and heart failure with mid-range ejection fraction (HFmrEF) in the observation group was higher than before treatment, and the N-terminal pro-Btype natriuretic peptide and left ventricular end-diastolic diameter decreased compared with those before treatment, with a statisticallysignificant difference in LVEF compared with the control group (P<0.05). Hypersensitivity C-reactive protein in the observation groupwas higher than that in the control group before treatment and lower than that in the control group after 12 weeks of treatment (P<0.05).There was no significant difference in hemoglobin, albumin, serum potassium, and serum creatinine between the two groups before andafter 12 weeks of treatment (P>0.05).Conclusion Sacubitril/valsartan can effectively reduce the blood pressure of MHD patients andimprove the LVEF of MHD combined with HFrEF and HFmrEF patients with better safety.
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