| | | 氯沙坦对高血压合并高尿酸血症患者血尿酸代谢和左室功能的影响
| | 中医学毕业论文【摘要】 目的中医学毕业论文 观察并分析氯沙坦对轻、中度原发性高血压合并高尿酸血症患者血尿酸代谢和左室功能的中医学毕业论文影响，并与非洛地平比较。方法 72例轻、中度原发性高血压合并高尿酸血症患者随机、单盲分为2组，治疗组36例，用氯沙坦50mg，po，qd；对照组36例，用非洛地平5mg，po，qd；2组用药4周末如坐位舒张压≥12kPa或收缩压≥18.7kPa者剂量加倍，疗程均为8周。结果 8周末降压总有效率治疗组为81%，对照组为75%，2组间比较，P＞0.05。血尿酸水平在8周末治疗组下降（-126±38）μmol/L（P<0.01），对照组下降（-25±32）μmol/L（P＞0.05），2组间比较，P<0.01。左室功能指标在8周末治疗组IVST、LVPWT、LVMI明显降低（P<0.01），LVEF明显升高（P<0.01），IVST、LVPWT、LVMI、LVEF2组间比较，P<0.05。结论 氯沙坦不仅能有效降压，而且能降低血尿酸水平，改善左室功能。
【关键词】 氯沙坦；高血压；高尿酸血症；左室功能
【Abstract】 Objective To observe and analyze the effects of losartan on serum uric acid metabolism and LV function of patients with mild to moderate essential hypertension complicatedby with hyperuricemia，which is also compared with felodipine.Methods Seventytwo patients with mild to moderate essential hypertension complicatedby hyperuricemia were randomly divided into treatment group (n=36) and control group (n=36).Patients of the treat group received losartan 50mg，po，qd for 4wk and those of the control group received felodipine 5mg，po，qd for 4wk，then，followed by dose doubling for another 4wk in those patients with seated diastolic blood pressure≥12kPa or systolic blood pressure≥18.7kPa.Results At the end of 8wk treatment，the total effective rates of decompression was 81% for the treatment group and 75% for the control group，respectively.There was no significant diffierence in curative effect between the two groups，P＞0.05.Compared with pretreatment，the serum uric acid level was descented （-126±38）μmom/L in the treatment group and （-25±32）μmom/L in the control group.The total effective rates were 72% and 11%，respectively.There was significant difference between the two groups，P<0.01.After 8 wk treatment，the IVST，LVPWT and LVMI of LV function descented while LVEF of LV function ascended apparently (P<0.01）.There was significant difference between two groups in IVST，LVPWT，LVMI and LVEF of LV function (P<0.01）.Conclusion Losartan can not only reduce blood pressure but also decrese serum uric acid level and improve LV function.
【Key words】 losartan；hypertension；hyperuricemia；LV function
近年来，大量的流行病学和临床研究证实，血尿酸升高与高血压病和心血管事件相关联，使高尿酸血症与高血压和心血管事件之间的关系日益受到人们的关注。为此，本研究应用氯沙坦治疗高血压合并高尿酸血症患者，探讨其对血压、血尿酸和左室功能的影响。
1 资料与方法
1.1 一般资料 选自2004年1月～2005年1月间两家医院内科门诊与住院的轻、中度高血压病患者共72例，其中男32例，女40例；年龄45～78岁。所有入选患者均符合1995年WHO/ISH高血压治疗指南制定的高血压诊断标准，排除继发性高血压、严重冠心病、糖尿病和肾功能不全者。所有病人血尿酸水平男性＞420μmol/L，女性＞360μmol/L，为存在高尿酸血症。随机分为两组：治疗组36例，其中男17例，女19例；年龄46～77岁；对照组36例，其中男16例，女20例；年龄45～77岁。两组患者年龄、性别、血压、血尿酸水平差异无显著性，具有可比性。
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