硝苯地平控释片联合沙库巴曲缬沙坦钠片治疗高血压伴脑出血的临床效果

Clinical Effect of Nifedipine Controlled-release Tablets Combined with Sacubitril Valsartan Sodium Tablets in the Treatment of Hypertension with Cerebral Hemorrhage

目的:探讨硝苯地平控释片联合沙库巴曲缬沙坦钠片治疗高血压伴脑出血的临床效果。方法:选取2020年9月—2022年9月大连医科大学附属第二医院收治的老年基底节区高血压伴脑出血患者150例作为研究对象,以随机数字表法分为对照组与研究组,各75例。对照组采用硝苯地平控释片治疗,研究组在对照组基础上给予沙库巴曲缬沙坦钠片治疗。比较两组美国国立卫生研究院卒中量表(NIHSS)和日常生活活动能力量表(ADL)评分、脑水肿体积及血清水通道蛋白4(AQP4)和Toll样受体4(TLR4)水平、治疗效果、并发症率。结果:治疗后,两组NIHSS评分均降低,ADL评分均升高,研究组NIHSS评分低于对照组,ADL评分高于对照组,差异有统计学意义(P<0.05);治疗1周和2周后,两组脑水肿体积、AQP4和TLR4水平随治疗时间呈下降趋势,且研究组均低于对照组,差异有统计学意义(P<0.05);研究组治疗总有效率高于对照组,并发症发生率低于对照组,差异有统计学意义(P<0.05)。结论:硝苯地平控释片联合沙库巴曲缬沙坦钠片治疗高血压伴脑出血患者的临床效果显著,可改善患者神经功能、日常生活能力、脑水肿体积及AQP4、TLR4水平,安全性较高。

Objective:To investigate the clinical effect of nifedipine controlled-release tablets combined with sacubitril valsartan sodium tablets in the treatment of hypertension with cerebral hemorrhage.Methods:One hundred and fifty cases of elderly patients with basal ganglia hypertension with cerebral hemorrhage admitted to the Second Affiliated Hospital of Dalian Medical University from September 2020 to September 2022 were selected as the study subjects,and were divided into the control group and the study group,seventy-five cases each,with the method of randomized numerical table.The control group was treated with nifedipine controlled-release tablets,and the study group was treated with sacubitril valsartan sodium tablets on the basis of the control group.The National Institutes of Health Stroke Scale(NIHSS)and Activities of Daily Living(ADL)scores,cerebral edema volume and serum aquaporin 4(AQP4)and Toll-like receptor 4(TLR4)levels,treatment effects,and complication rates were compared between the two groups.Results:After treatment,NIHSS scores decreased and ADL scores increased in both groups,and NIHSS scores in the study group were lower than those in the control group,and ADL scores were higher than those in the control group,with statistically significant differences(P<0.05);After 1 and 2 weeks of treatment,the volume of cerebral edema,AQP4 and TLR4 levels in both groups showed a decreasing trend with the treatment time,and both of them were lower in the study group than in the control group,and the difference was statistically significant(P<0.05);The total effective rate of treatment in the study group was higher than that in the control group,and the complication rate was lower than that in the control group,with statistically significant differences(P<0.05).Conclusion:The clinical effect of nifedipine controlled-release tablets combined with sacubitril valsartan sodium tablets in the treatment of patients with hypertension with cerebral hemorrhage is remarkable,which can improve the patients'neurological function,ability of daily life,volume of cerebral edema,and the levels of AQP4 and TLR4,and the safety is high.