替米沙坦联合吲达帕胺对老年高血压伴高尿酸血症患者尿酸的影响

Effect of telmisartan combined with indapamide on uric acid in elderly hypertensive patients with hyperuricemia

目的观察替米沙坦联合吲达帕胺对老年高血压伴高尿酸血症患者尿酸的影响。方法将120例老年高血压患者随机分成3组,每组40例,对照组服用氨氯地平降压治疗(5 mg/d,n=39),替米沙坦组单独服用替米沙坦(80 mg/d,n=38),联合治疗组同时服用替米沙坦(80 mg/d,n=36)与吲达帕胺(1.5 mg,n=36),治疗3个月后分别测血压及空腹血尿酸(serum uric acid,BUA),分别评估对收缩压(systolic blood pressure,SBP)、舒张压(diastolic blood pressure,DBP)及BUA影响。结果治疗3个月后,共有113例具有完整的随访信息,3组SBP、DBP均较基线血压显著下降(P<0.01),联合治疗组SBP、DBP降幅均大于对照组及替米沙坦组(P<0.05)。BUA水平,替米沙坦组较对照组下降(P<0.05),但联合治疗组与对照组比较差异无统计学意义(P>0.05)。结论替米沙坦与吲达帕胺联合应用能显著增强降压作用;替米沙坦有降低原发性高血压患者BUA水平的作用,但两者联合应用后减弱其降低BUA的作用。

Objective To study the effect of telmisartan combined with indapamide on uric acid in elderly hypertensive patients. Methods 113 elderly hypertensive patients were randomly divided into three groups： the control group was given amlodipine （5 rag/d, n = 39） , the telmisartan group took telmisartan（ 80 rag/d, n = 38 ） alone, while the combined treatment group took telmisartan combined with indapamide （80 mg/15mg, n = 36）. After three months of treatment, there blood pressure and serum uric acid were measured in the three groups. Results After three months, systolic blood pressure （SBP） and diastolic blood pressure （DBP） were significantly decreased in the three groups compared with baseline （ all P 〈 0.01 ） , especially in the combined treatment group （ all P 〈 0.05 ）. The serum uric acid level decreased more significantly in the telmisartan group than in the control group （ P 〈 0.05 ）, but there was no significant difference （ P 〉 0.05 ） between the combined treatment group and the control group. Conclusions Telmisartan com- bined with indapamide significantly enhances the antihypertensive effect, and telmisartan can reduce the level of serum acid （BUA） in patients with essential hypertension, but the combined treatment reduces the effect of decreasing BUA.