目的:评价依帕利列净联合沙库巴曲/缬沙坦治疗高血压合并心力衰竭的疗效。重点研究其对血压变异性(BPV)和心脏功能的影响。
方法:这项回顾性研究包括2021年10月至2023年10月在宝鸡市高科技医院接受治疗的101例高血压和心力衰竭患者。将患者分为两组:观察组(n=51),用依帕列净和沙库巴曲/缬沙坦治疗,和对照组(n=50),单独用沙库巴曲/缬沙坦治疗。我们比较了治疗效果,BPV(包括24小时,白天,和夜间收缩压和舒张压BPV),心功能指标,治疗前后N末端脑钠肽前体(NT-proBNP)和肌钙蛋白I(cTnI)水平,以及组间不良反应的发生率。分析影响疗效的独立危险因素。
结果:观察组治疗总有效率明显高于对照组(P<0.05)。两组治疗后白天和夜间收缩压和舒张压BPV均降低,观察组改善更为明显(均P<0.05)。增强心脏超声测量,NT-proBNP水平,观察组治疗后cTnI水平高于对照组(均P<0.05)。两组治疗期间不良反应发生率比较,差异无统计学意义(P>0.05)。年龄和合并糖尿病是预后不良的独立危险因素。而依帕格列净联合沙库巴曲/缬沙坦治疗是一个保护因素。
结论:Empagliflozin联合沙库巴曲/缬沙坦可显著提高高血压合并心力衰竭患者的治疗效果。有效改善心脏功能和BPV,并表现出良好的安全性。
OBJECTIVE: To evaluate the efficacy of empagliflozin combined with sacubitril/valsartan in treating hypertensive patients with heart failure (HF), focusing on its effects on blood pressure variability (BPV) and cardiac function.
METHODS: This retrospective study included 101 patients with hypertension and heart failure with reduced ejection fraction treated at Baoji High-Tech Hospital from October 2021 to October 2023. Patients were divided into two groups: an observation group (n=51), treated with both empagliflozin and sacubitril/valsartan, and a control group (n=50), treated with sacubitril/valsartan alone. We compared the therapeutic effects, BPV (including 24-hour, daytime, and nighttime systolic and diastolic BPV), cardiac function indicators, levels of N-terminal pro-brain natriuretic peptide (NT-proBNP) and cardiac troponin I (cTnI) before and after treatment, and the incidence of adverse reactions between the groups. Independent risk factors affecting treatment efficacy were also analyzed.
RESULTS: The total effective rate of treatment in the observation group was significantly higher than in the control group (P<0.05). Both groups showed reductions in daytime and nighttime systolic and diastolic BPV after treatment, with the observation group displaying more pronounced improvements (all P<0.05). Enhancements in cardiac ultrasound measurements, NT-proBNP levels, and cTnI levels were more significant in the observation group compared to the control group post-treatment (both P<0.05). There was no significant difference in the incidence of adverse reactions during treatment between the two groups (P>0.05). Age and comorbid diabetes were identified as independent risk factors for poor prognosis, while treatment with empagliflozin combined with sacubitril/valsartan was a protective factor.
CONCLUSIONS: Empagliflozin combined with sacubitril/valsartan significantly enhances treatment efficacy in hypertensive patients with heart failure, effectively improves cardiac function and BPV, and demonstrates good safety.