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沙库巴曲缬沙坦对比贝那普利用于围绝经期高血压患者的临床

观察
Δ

张晓霞 ，邵柏林，周英坤，张占海，李志英（南阳医学高等专科学校第一附属医院心血管内科，河南 南阳
＊
473058）

中图分类号 R969.4；R714.25 文献标志码 A 文章编号 1001-0408（2026）04-0476-04
DOI 10.6039/j.issn.1001-0408.2026.04.11

摘 要 目的 比较沙库巴曲缬沙坦与贝那普利用于围绝经期高血压患者的降压效果及对心室重构、炎症纤维化的影响。方法
回顾性收集我院2023年1月1日至2024年12月30日收治的206例围绝经期高血压患者资料，按用药的不同分为贝那普利组（105
例）和沙库巴曲缬沙坦组（101例）。贝那普利组患者给予盐酸贝那普利片，沙库巴曲缬沙坦组患者给予沙库巴曲缬沙坦钠片，所
有患者均治疗6个月。观察并比较两组患者治疗前后的血压（收缩压、舒张压）及血压达标情况、心脏超声指标（左室射血分数、左
室质量指数、相对壁厚、二尖瓣口舒张早期峰值血流速度/二尖瓣环舒张早期峰值运动速度）、炎症纤维化相关指标（超敏C反应蛋
白、单核细胞与淋巴细胞比值、中性粒细胞与淋巴细胞比值）及不良反应（低血压、高钾血症、血管性水肿）发生情况。结果 沙库巴
曲缬沙坦组患者的血压达标率显著高于贝那普利组（P＜0.05）。治疗后，两组患者的血压、心脏超声指标（左室射血分数除外）、炎
症纤维化相关指标水平均显著低于同组治疗前，且沙库巴曲缬沙坦组显著低于同期贝那普利组（P＜0.05）。两组患者低血压、高
钾血症、血管性水肿的发生率及不良反应总发生率比较，差异均无统计学意义（P＞0.05）。结论 与贝那普利比较，沙库巴曲缬沙
坦能更有效地控制围绝经期高血压患者的血压，逆转心室重构及抑制炎症纤维化，且二者的安全性相当。
关键词 沙库巴曲缬沙坦；贝那普利；围绝经期；高血压；心室重构；炎症纤维化

Clinical observation of sacubitril/valsartan versus benazepril in perimenopausal hypertensive patients
ZHANG Xiaoxia，SHAO Bolin，ZHOU Yingkun，ZHANG Zhanhai，LI Zhiying（Dept. of Cardiovascular
Medicine， the First Affiliated Hospital of Nanyang Medical College， Henan Nanyang 473058， China）

ABSTRACT OBJECTIVE To compare the antihypertensive efficacy of sacubitril/valsartan versus benazepril in patients with
perimenopausal hypertension， as well as their impacts on ventricular remodeling and inflammatory fibrosis. METHODS A total of
206 perimenopausal hypertensive patients in our hospital from January 1， 2023 to December 30， 2024 were retrospectively included.
These patients were enrolled and divided into benazepril group （105 cases） and sacubitril/valsartan group （101 cases）. Benazepril
group received Benazepril hydrochloride tablet， and sacubitril/valsartan group received Sacubitril valsartan sodium tablet. All
patients were treated for 6 months. The blood pressure（systolic blood pressure and diastolic blood pressure） and blood pressure
control status before and after treatment， echocardiographic indicators （left ventricular ejection fraction， left ventricular mass
index， relative wall thickness， and early-diastolic peak transmitral flow velocity/early-diastolic peak velocity of the mitral annulus），
inflammatory fibrosis related indicators（high-sensitivity C-reactive protein，ratio of monocytes to lymphocytes，and ratio of
neutrophils to lymphocytes）， as well as the occurrence of adverse reactions（hypotension，hyperkalemia，and angioedema） were
observed in both groups before and after treatment. RESULTS The blood pressure control rate was significantly higher in the
sacubitril/valsartan group than in benazepril group （P＜0.05）. After treatment， the blood pressure， echocardiographic indicators
（except for left ventricular ejection fraction） ，and inflammatory fibrosis related indicators were significantly lower than those before
treatment within the same group， and the sacubitril/valsartan group were significantly lower than the benazepril group （P＜0.05）.
There were no statistically significant differences in the incidence of hypotension， hyperkalemia， angioedema， and overall adverse
drug reactions between the two groups （P＞0.05）. CONCLUSIONS Compared with benazepril， sacubitril/valsartan provides
superior blood-pressure control， reverses ventricular remodeling， attenuates inflammatory fibrosis in perimenopausal hypertensive
patients， while maintaining a similar safety profile.
KEYWORDS sacubitril/valsartan； benazepril； perimenopause； hypertension； ventricular remodeling； inflammatory fibrosis

围绝经期女性由于雌激素水平的波动或下降，常伴 随交感神经活性及肾素-血管紧张素-醛固酮系统（renin-
angiotensin-aldosterone system，RAAS）过度激活，导致高
Δ 基金项目 河南省自然科学基金项目（No.20243MS026）
血压在此人群中的患病率显著升高 。我国 40～60 岁
[1]
＊第一作者 副主任医师。研究方向：心血管疾病临床研究。
E-mail：xiaoxiazhang123@163.com 围绝经期女性的高血压患病率约为 16.6%，且呈逐年升

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