沙库巴曲缬沙坦对心力衰竭患者相关炎症因子的影响

Effect of sakubatrevalsartan on related inflammatory factors in patients with heart failure

【目的】研究沙库巴曲缬沙坦对心衰患者血清一氧化氮、血管紧张素、金属基质蛋白酶及内皮型一氧化氮合成酶水平的影响。【方法】选取本院诊断的56例慢性心衰患者,将这些慢性心力衰竭患者先使用指南推荐的标准心力衰竭治疗方案常规剂量3个月作为导入期,筛除不耐受标准治疗患者后随机选取28例作为沙库巴曲缬沙坦低剂量及高剂量组,其余14例作为标准治疗对照组。对照组在一般治疗的基础上加用10 mg依那普利口服,2次/d。而沙库巴曲缬沙坦低剂量及高剂量组的患者在一般治疗的基础上加用100 mg/200 mg沙库巴曲缬沙坦口服,2次/d。比较3组治疗前后血浆一氧化氮、血管紧张素、金属基质蛋白酶及内皮型一氧化氮合成酶水平及其炎症因子相关性。【结果】治疗后,3组血浆一氧化氮、血管紧张素、金属基质蛋白酶及内皮型一氧化氮合成酶水平与同组治疗前相比存在显著性差异(P<0.05),且标准治疗组及沙库巴曲缬沙坦低剂量/高剂量组之间也存在显著性差异(P<0.05)。【结论】从炎症因子水平考虑,200 mg沙库巴曲缬沙坦可能是我国心衰患者更为优化的靶目标剂量。血管紧张素-Ⅱ水平与金属基质蛋白酶-2、内皮型一氧化氮合成酶水平正相关。同时内皮型一氧化氮合成酶、金属基质蛋白酶-2与一氧化氮水平负相关,值得临床进一步研究。

【Objective】To research the effect of sakubatrevalsartan on serum level of nitric oxide,angiotensin,metalloproteinase and endothelial nitric oxide synthetase in patients with heart failure.【Methods】56 patients diagnosised chronic heart failure were selected in Hanzhong Central hospital.The normal dose of the standard heart failure treatment scheme recommended by the guidelines was used as the lead-in period for 3 months.After screening out the patients for intolerant standard treatment,28 patients were randomly selected as the low-dose and high-dose groups of sakubatravsartan,and the other 14 patients were treated as the standard treatment control group.The patients in the standard treatment group were treated with 10 mg enalapril twice a day on the basis of general treatment.The patients in the low dose and high dose groups were treated with 100 mg/200 mg sakubatrevalsartan twice a day on the basis of general treatment.The serum levels of nitric oxide,angiotensin,matrix metalloproteinase and endothelial nitric oxide synthetase before and after treatment were compared among the three groups.【Results】After treatment,there was significant difference in the serum levels of nitric oxide,angiotension,metalloproteinase and endothelial nitric oxide synthetase among the three groups before and after treatment(P<0.05),and there was also significant difference between the standard treatment group and the low dose/high dose group of sakubatravalin(P<0.05).【Conclusion】Considering the level of inflammatory factors,200 mg of sakubatrevalsartan may be a more optimized target dose for patients with HF in China.The serum levels of metalloproteinase-2 and endothelial nitric oxide synthetase are positively correlated with Ang-Ⅱ.Meanwhile,endothelial nitric oxide synthetase and metalloproteinase-2 are negatively correlated with nitric oxide level,which are worthy of further clinical research.