沙库巴曲缬沙坦对老年高血压患者降压疗效及炎症因子影响
Effect of Sacubitril-Valsartan on Antihypertensive Efficacy Inflammatory Factors in Elderly Patients with Hyperten-sion

目的：比较沙库巴曲缬沙坦与缬沙坦对老年原发性高血压患者降压疗效及炎症因子水平的影响。方法：回顾性选取2021年7月1日至2022年7月1日在青岛大学附属医院住院的老年原发性高血压患者215例。根据患者服用降压药物不同分为沙库巴曲缬沙坦(200 mg/次 1次/天)组(n = 71)和缬沙坦组(80 mg/次 1次/天) (n = 82)。收集两组患者病历资料，观察患者8周后的诊室血压[平均坐位收缩压(mean sitting Systolic Blood Pressure, msSBP)、平均坐位舒张压(mean sitting Diastolic Blood Pressure, msDBP)]和炎症因子[(白细胞介素-1β (Interleukin 1β, IL-1β)、IL-2、IL-4、IL-5、IL-6、IL-8、IL-10、IL-17、肿瘤坏死因子(Tumor Necrosis Factor, TNF)-α (TNF-α)]差异。结果：沙库巴曲缬沙坦钠组患者治疗8周以后的诊室血压下降幅度和诊室血压达标率较缬沙坦组高(P < 0.05)；两组患者治疗8周以后血浆IL-1β、IL-6、IL-10、IL-17、TNF-α的差值组内比较有统计学意义(P < 0.05)；沙库巴曲缬沙坦组患者IL-17的下降幅度明显高于缬沙坦组、抑炎因子IL-10的升高幅度明显高于缬沙坦组(P均 < 0.05)；余细胞因子(IL-4、IL-6、IL-8、IL-1β、IL-2、IL-5、TNF-α)两组间无明显统计学差异。结论：在原发性高血压的药物治疗中，与缬沙坦相比，沙库巴曲缬沙坦能更好地降低诊室血压，提高诊室血压达标率，其机制可能与降低体内促炎因子(IL-17)水平，提高体内抑炎因子(IL-10)水平有关。
Objective: To compare the effect of sacubitril-valsartan and valsartan on antihypertensive efficacy and inflammatory factor levels in elderly patients with essential hypertension. Methods: A total of 215 elderly patients with essential hypertension who were hospitalized in the Affiliated Hospital of Qingdao University from July 1, 2021 to July 1, 2022 were selected. Patients were divided into sacu-bitril- valsartan (200 mg/qd) group (n = 71) and valsartan (80 mg/qd) group (n = 82) according to the different antihypertensive drugs taken. The medical records of the two groups of patients were collected to observe the difference in clinic’s blood pressure [mean sitting Systolic Blood Pressure (msSBP), mean sitting Diastolic Blood Pressure (msDBP)] and inflammatory factors [Interleukin 1β (IL-1β), IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-17, Tumor Necrosis Factor-α (TNF-α)] after 8 weeks. Re-sults: After 8 weeks of treatment, the decrease in office blood pressure and the rate of meeting the standard of office blood pressure in the sacubitril-valsartan group after 8 weeks of treatment were higher than those in the valsartan group (P < 0.05), the levels of IL-1β, IL-6, IL-10, IL-17 and TNF-α were statistically significant compared with those before treatment (P < 0.05), the decrease of IL-17 in the sacubitril-valsartan group was significantly higher than that in the valsartan group, the in-crease in inflammatory factor IL-10 was significantly higher than that in the valsartan group (P < 0.05). There was no significant difference in the other inflammatory factors (IL-4, IL-6, IL-8, IL-1β, IL-2, IL-5, TNF-α) between the two groups. Conclusion: In the treatment of essential hypertension, sacubitril-valsartan can better reduce office blood pressure and improve office blood pressure com-pliance