沙库巴曲缬沙坦对老年高血压合并射血分数保留心力衰竭患者血清胱抑素C和半乳糖凝集素-3的影响

The Effects of Sacubitril/Valsartan on Serum Levels of Cystatin C and Galectin-3 in Old Hypertensive Patients of Heart Failure with Pre-served Ejection Fraction

探讨沙库巴曲缬沙坦对老年高血压合并射血分数保留心力衰竭患者血清胱抑素C和半乳糖凝集素-3的影响。选取2020年1月至2022年10月于本院就诊的罹患老年高血压合并射血分数保留心力衰竭患者126例,将患者分为沙库巴曲缬沙坦组和缬沙坦组,分别治疗3个月。采用24 h动态血压评估患者治疗前后血压情况,心脏彩超评估心功能情况,并观察患者治疗前后血清胱抑素C和半乳糖凝集素-3水平的变化。本研究纳入的高血压合并射血分数保留心力衰竭的老年患者中,两组间在治疗前血压、心功能及血清胱抑素C和半乳糖凝集素-3水平均无明显差异(P>0.05)。给予沙库巴曲缬沙坦或缬沙坦治疗后,与治疗前基线水平相比,两组患者24 h平均收缩压及24 h平均舒张压均明显下降,左室射血分数明显升高,且血清胱抑素C和半乳糖凝集素-3水平较治疗前亦有明显降低(P<0.05)。与缬沙坦组相比,沙库巴曲缬沙坦组患者血压下降更明显(P<0.05),左室射血分数更高(P<0.01),血清胱抑素C和半乳糖凝集素-3水平更低(P<0.05)。本研究结果提示,沙库巴曲缬沙坦可以在有效降低血压的同时,更好地改善老年高血压合并射血分数保留心力衰竭患者的心功能和病理性重构指标。未来需要更大规模的多中心前瞻性研究证明沙库巴曲缬沙坦在改善老年高血压合并射血分数保留心力衰竭患者心血管事件及预后中的确切作用。

To investigate the effects of sacubitril/valsartan on serum levels of cystatin C and galectin-3 in old hypertensive patients of heart failure with preserved ejection fraction,hypertensive patients of heart failure with preserved ejection fraction were enrolled between January 2020 and October 2022.A total of 126 patients were divided into sacubitril/valsartan users and valsartan users,and received treatment for 3 months.The changes of 24 h blood pressure and cardiac function,as well as the serum levels of cystatin C and galectin-3 were investigated before and after treatment.The results showed that the 24 h systolic blood pressure and 24 h dias-tolic blood pressure were decreased after treatment in both of groups(P<0.05).Cardiac function as displayed by left ventricular ejection fraction was increased by both sacubitril/valsartan and valsartan treatment(P<0.01).Moreover,serum levels of cystatin C and galectin-3 were also decreased after treatment(P<0.05).Importantly,patients in the sacubitril/valsartan group had lower 24 h systolic blood pressure and 24 h diastolic blood pressure as well as higher left ventricular ejection fraction than those in the valsartan group(P<0.05).In addition,the serum levels of cystatin C and galectin-3 were also lower in the sacubitril/valsartan group than in the valsartan group after treatment.In conclusion,the results indicate that the use of sacubitril/valsartan could significantly improve cardiac dysfunction and cardiac remodeling accompanied by effectively controlling the blood pressure in old hypertensive patients of heart failure with preserved ejection fraction.Further prospective multicenter studies will be needed to confirm the effects of sacubi-tril/valsartan on the prognosis of lower risk of hypertensive patients of heart failure with preserved ejection fraction.