缬沙坦对老年原发性高血压伴轻度认知障碍病情改善及血清同型半胱氨酸、基质金属蛋白酶-9水平的影响

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摘要目的探讨缬沙坦对老年原发性高血压伴认知功能障碍患者病情改善及对血清同型半胱氨酸（Hcy）、基质金属蛋白酶-9（MMP-9）水平的影响。方法选取2019 年1 月至2022 年12 月联勤保障部队第九二一医院收治的142 例老年原发性高血压伴轻度认知功能障碍患者为研究对象，采用随机数字表法将其分为观察组（n=71）和对照组。观察组给予缬沙坦胶囊降压治疗，对照组给予苯磺酸左氨氯地平降压治疗，观察并比较两组患者治疗前后的心率、血压、认知功能、血清Hcy 和MMP-9 水平变化情况。结果两组患者治疗前后组间、组内的心率比较，差异无统计学意义（P＞0.05）。两组治疗前的收缩压、舒张压水平比较，差异无统计学意义（P＞0.05）；观察组治疗后的收缩压低于对照组，差异有统计学意义（P＜0.05）；但治疗后两组的舒张压比较，差异无统计学意义（P＞0.05）。两组患者治疗前的认知功能各项评分及总分比较，差异无统计学意义（P＞0.05）；观察组治疗后的延迟回忆、抽象、注意、语言4 项维度和认知功能总分高于对照组，差异有统计学意义（P＜0.05），两组治疗后的命名、定向、视空间与执行功能评分比较，差异无统计学意义（P＞0.05）。两组患者治疗前血清Hcy 及MMP-9 水平比较，差异无统计学意义（P＞0.05），观察组治疗后的血清Hcy 及MMP-9 水平低于对照组，差异有统计学意义（P＜0.05）。结论老年原发性高血压伴轻度认知功能障碍的患者采用缬沙坦和苯磺酸左氨氯地平均可降低血压、改善认知功能障碍、降低血清Hcy、MMP-9 水平，相比之下，缬沙坦的作用效果更为明显，值得在临床上推广实施。

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关键词 ：缬沙坦, 苯磺酸左氨氯地平, 原发性高血压, 认知功能障碍, 同型半胱氨酸, 基质金属蛋白酶-9

Abstract：Objective To explore the effect of Valsartan on the condition improvement and serum homocysteine (Hcy)and matrix metalloproteinase-9(MMP-9)levels in elderly patients with essential hypertension and cognitive dysfunction.Methods A total of 142 elderly patients with essential hypertension combined with mild cognitive impairment admitted to the 921st Hospital of Joint Logistic Support Force of PLA from January 2019 to December 2022 were selected as the study objects,and were divided into observation group and control group by random number table method,with 71 cases in each group.The observation group was treated with Valsartan Capsules,and the control group was treated with Levamlodipine Besilate.The changes of heart rate,blood pressure,cognitive function,serum Hcy and MMP-9 levels before and after treatment were observed and compared between the two groups.Results There was no significant difference in heart rate between and within two groups before and after treatment (P＞0.05).There was no significant difference in the levels of systolic and diastolic blood pressure between the two groups before treatment (P＞0.05).The systolic blood pressure of the observation group was lower than that of the control group after treatment,and the difference was statistically significant (P＜0.05).However,there was no significant difference in diastolic blood pressure between the two groups after treatment (P＞0.05).There was no significant difference in the scores and total scores of cognitive function between the two groups before treatment (P＞0.05).After treatment,the four dimensions of delayed recall,abstraction,attention and language and the total score of cognitive function in the observation group were higher than those in the control group,and the differences were statistically significant(P＜0.05).There were no statistically significant differences in naming,orientation,visual spatial and executive function scores between the two groups after treatment(P＞0.05).There was no significant difference in serum Hcy and MMP-9 levels between the two groups before treatment (P＞0.05),but the serum Hcy and MMP-9 levels in the observation group were lower than those in the control group after treatment,and the differences were statistically significant(P＜0.05).Conclusion In elderly patients with essential hypertension with mild cognitive dysfunction,Valsartan and Levamlodipine Besilate can reduce blood pressure,improve cognitive dysfunction,and reduce serum Hcy and MMP-9 levels on average.In comparison,Valsartan has more obvious effects,which is worthy of clinical promotion and implementation.

Key words： Valsartan Levamlodipine Besilate Essential hypertension Cognitive impairment Homocysteine Matrix metallopeptidase 9

基金资助:湖南省教育厅科学研究项目（20C1140）。

引用本文:

李宇宁1；刘雅婷1；杨东2 ；张文华3；曾妮4；蔡亚敏1▲. 缬沙坦对老年原发性高血压伴轻度认知障碍病情改善及血清同型半胱氨酸、基质金属蛋白酶-9水平的影响[J]. 中国当代医药, 2024, 31(11): 75-79.
LI Yuning1 LIU Yating1 YANG Dong2 ZHANG Wenhua3 ZENG Ni4 CAI Yamin1▲. Effect of Valsartan on the improvement of the condition and serum homocysteine and matrix metalloproteinase-9 levels in elderly patients with essential hypertension and mild cognitive impairment. 中国当代医药, 2024, 31(11): 75-79.

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https://www.dangdaiyiyao.com/CN/ 或 https://www.dangdaiyiyao.com/CN/Y2024/V31/I11/75

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