目的 探讨沙库巴曲缬沙坦钠联合拉西地平治疗高血压的临床疗效。方法 选取2022年11月—2024年5月郑州人民医院心血管内科收治的126例高血压患者，依据随机数字法现将入组高血压患者分为对照组63例和治疗组63例。对照组患者给予口服拉西地平分散片，4 mg/次，1次/d。治疗组在对照组的基础上给予口服沙库巴曲缬沙坦钠片，100 mg/次，2次/d。两组用药42 d观察治疗情况。观察两组临床疗效和临床症状缓解时间，比较两组治疗前后收缩压、舒张压、血清血管内皮因子、血清炎性因子水平的变化。结果 用药42 d后，治疗组总有效率96.83%，显著高于对照组的84.13%（P＜0.05）。用药42 d后，治疗组患者头晕、耳鸣、头痛、心律失常症状缓解时间显著短于对照组（P＜0.05）。治疗后，两组患者内皮素-1（ET-1）、血管内皮生长因子（VEGF）水平显著降低，而一氧化氮（NO）、降钙素基因相关肽（CGRP）水平升高（P＜0.05）；治疗后，治疗组ET-1、VEGF水平低于对照组，NO、CGRP高于对照组（P＜0.05）。治疗后，两组可溶性生长刺激表达基因2蛋白（sST2）、白细胞介素-8（IL-8）、转化生长因子-β1（TGF-β1）、肿瘤坏死因子-α（TNF-α）水平均显著降低（P＜0.05）；治疗后，与对照组对比，治疗组sST2、IL-8、TNF-α、TGF-β1水平均较低（P＜0.05）。结论 沙库巴曲缬沙坦钠联合拉西地平治疗高血压疗效显著，可明显缓解高血压症状，并能调节血管内皮因子功能，减弱机体炎性反应，值得借鉴与应用。

Objective To investigate the therapeutic effect of lacidipine combined with sacubitril valsartan sodium in treatment of hypertension. Methods A total of 126 hypertensive patients admitted to the cardiovascular Department of Zhengzhou People's Hospital from November 2022 to May 2024 were selected and divided into control group (63 cases) and treatment group (63 cases) according to random number method. Patients in control group were po administered with Lacidipine Dispersible Tablets, 4 mg/time, once daily. Patients in treatment group were po administered with Sacubitril Valsartan Sodium Tablets on the basis of control group, 100 mg/time, twice daily. The two groups were treated for 42 d to observe the treatment. The clinical effects and duration of relief of clinical symptoms of two groups were observed, and the changes of systolic blood pressure, diastolic blood pressure, serum vascular endothelial factors and serum inflammatory factors before and after treatment were compared. Results After 42 d of treatment, the total effective rate of treatment group was 96.83%, which was significantly higher than that of control group (84.13%, P < 0.05). After 42 d of medication, the relief time of dizziness, tinnitus, headache and arrhythmia in treatment group was significantly shorter than that in control group (P < 0.05). After treatment, the levels of ET-1 and VEGF were significantly decreased, but the levels of NO and CGRP were increased in 2 groups (P < 0.05). After treatment, the levels of ET-1 and VEGF in treatment group were lower than those in control group, but the levels of NO and CGRP were higher than those in control group (P < 0.05). After treatment, the levels of sST2, IL-8, TGF-β1, and TNF-α were significantly decreased in both groups (P < 0.05). After treatment, the levels of sST2, IL-8, TNF-α and TGF-β1 in treatment group were lower than those in control group (P < 0.05). Conclusion Lacidipine combined with sacubitril valsartan sodium is effective in treatment of hypertension, and can significantly relieve the symptoms of hypertension, regulate the function of vascular endothelial factors, and weaken the inflammatory response of the body, which is worth learning and application.

R972

河南省医学科技攻关计划联合共建项目（LHGJ20220803）