沙库巴曲缬沙坦治疗高血压患者高原反应的效果分析

Analysis of the effects of sacubitril valsartan in treating altitude sickness in hypertensive patients

目的 探讨沙库巴曲缬沙坦治疗高血压患者高原反应的效果。方法 回顾性选择2020年11月到2021年11月于天水市第一人民医院接受治疗的勺型高血压高原反应患者作为研究对象。按照是否采用沙库巴曲缬沙坦治疗,分为观察组和对照组。比较两组患者急性高原病临床症状量表(AMS)评分、最大摄氧量(VO2max)、脉博血氧饱和度(SpO2)、动脉血氧饱和度(SaO2)及肺活量(VC)。记录患者不良反应发生情况,包括血管性水肿、低血压、肾功能损害及高钾血症。结果 本研究共纳入159例患者,观察组102例,对照组57例。出现高原反应4 h(t=7.299,P<0.01)、6 h(t=5.552,P<0.01)时,两组AMS评分比较,观察组AMS评分高于对照组,差异有统计学意义(P<0.05)。VO2 max(t=15.204,P<0.01)、SaO2(t=6.502,P<0.01)及SpO2(t=2.918,P<0.01)比较,观察组的VO2 max水平显著低于对照组,SaO2、SpO2水平显著均高于对照组,两组差异均有统计学意义(P<0.05)。采用Pearson检验分析各实验室指标间的相关性,AMS评分与VO2 max呈负相关,与SaO2、SpO2均呈正相关(P<0.05)。两组不良反应发生率比较,观察组的血管性水肿(χ2=7.750,P<0.01)、低血压(χ2=13.319,P<0.01)、肾功能损害(χ2=5.997,P=0.014)及高钾血症(χ2=6.113,P=0.013)的发生率分别为10.78%、5.88%、8.82%、0.98%,显著低于对照组的28.07%、26.32%、22.81%、8.77%,两组比较差异有统计学意义(P<0.05)。随机行走模型结果显示,观察组较对照组相比,行走步数较少,正向递增率较高,更适合临床应用。结论 沙库巴曲缬沙坦对高血压患者高原反应具有一定的治疗作用。

Objective To explore the effect of sacubitril valsartan on altitude sickness in hypertensive patients. Methods Patients with scoop type hypertension who visited Tianshui First People’s Hospital from November 2020 to November 2021were included. According to whether patients received sacubitril valsartan treatment, they were divided into the observation group and control group. Acute mountain sickness clinical symptom scale(AMS) scores were compared between the two groups. Oxygen uptake(VO2 max), finger pulse oxygen and blood oxygen saturation(SpO2), oxygen saturation(SaO2) and vital capacity(VC) were measured and compared. Adverse reactions were recorded, including angioedema, hypotension, renal impairment, and hyperkalemia. Results A total of 159 patients were included, 102 patients in the observation group, and 57patients in the control group. The AMS score of the observation group was statistically higher than that of the control group at 4 h(t=7. 299, P<0. 01) and 6 h(t=5. 552, P<0. 01). For VO2 max(t=15. 204, P<0. 01), SaO2(t=6. 502, P<0. 01), SpO2(t=2. 918, P<0. 01), the VO2 maxlevel of the observational group was statistically lower than the control group, SaO2and SpO2levels were higher than the control group. The correlation between the laboratory indicators was analyzed by Pearson test. AMS score was negatively correlated with VO2 max, while AMS score was positively correlated with SaO2and SpO2, respectively(P<0. 05). Concerning safety, the observational group had statistically lower incidence of angioedema(10. 78% vs 28. 07%, χ~2=7. 750, P<0. 01), hypotension(5. 88% vs 26. 32%, χ~2=13. 319, P<0. 01), renal impairment(15. 78% vs 22. 81%, χ~2=5. 997, P=0. 014) and hyperkalemia(0. 98% vs 8. 77%, χ~2 =6. 113, P=0. 013) compared with the control group. The random walking model reflected that the observation group had a lower number of walking steps and a higher positive increase rate compared with the control group, which is more suitable for clinical application. Conclusion Sacubitril valsartan may have therapeutic effect on altitude sickness in hypertensive patients.