A Study of Effects and Potential Mechanism ofSacubitril/Valsartan in the Treatment of Hypertension Complicated with Renal Insufficiency
Objective To investigate the clinical effect and potential mechanism of shakubactrivalsartan in the treatment of hypertension combined with renal insufficiency,and to provide a novel reference for the treatment strategy of hypertension combined with renal insufficiency.Methods mRNA microarray of studies related to hypertension combined with renal insufficiency was retrieved from the database.GSE70528 dataset was then selected as the research object.Differential genes were selected and protein interaction network was constructed.A total of 120 patients with hypertension combined with renal insufficiency admitted to hospital from March,2022 to October,2022 were selected and randomly divided into the control group (n=60 )and observation group (n=60 ).The control group was given one or more non-ARB antihypertensive drugs,while the observation group was given sacubitril/valsartan.Blood pressure,renal function indexes and inflammatory factors were detected before and 2 months after treatment,and the expression changes of potential target genes were detected by real-time fluorescence quantitative PCR.Results A total of 20549 genes were detected.Compared with the hypertensive group,14 genes were up-regulated and 57 genes were down-regulated in the observation group.Protein interaction analysis showed that ISG15,IFI44, IFI44L,IFIT2,OAS3,OASL and RSAD2 were in the core position of the network.After treatment, the blood pressure (systolic blood pressure,diastolic blood pressure and mean arterial pressure)in the observation group was significantly lower than that in the control group.Levels of renal function indexes (BUN,Scr,CysC,eGFR,α1-MG,β2-MG,NAG)and inflammatory factors (IL-1,IL-6, IL-10 and TNF-α)were significantly improved compared with the control group (all P<0.05 ). Compared with the control group,expression levels of OASL,IFI44,IFIT2 and RSAD2 in the observation group were significantly increased (P<0.05).Conclusion Shacubartrivalsartan can reduce blood pressure, improve renal function and have anti-inflammatory effects on patients with hypertension and renal function,in which OASL,IFI44,IFIT2 and RSAD2 might be involved in the occurrence and development of hypertension and renal insufficiency.OASL, IFI44, IFIT2 and RSAD2 could be used as targets.It can provide a novel method for clinical treatment of hypertension complicated with renal insufficiency.
万方数据
维普
