联合用药治疗肥胖型高血压合并高尿酸血症的临床观察

Losartan Combination with Metformin Therapy of Obesity-Associated Hypertension and Hyperuricemia

目的 观察氯沙坦联合二甲双胍对肥胖型高血压患者血压、体重指数(BMI)、腰围(WC)、血脂及尿酸的影响。方法 70例诊断为肥胖型高血压合并高尿酸血症的患者随机分成观察组(35例)和对照组(35例),观察组患者给予二甲双胍(500mg)+氯沙坦(50mg)治疗;对照组患者给予氯沙坦(50mg)治疗,共24周,治疗前及治疗24周后测定血脂、BMI、WC、尿酸水平。每2周门诊随访并记录血压。结果 ①2组患者血压均明显降低,P<0.05,但氯沙坦+二甲双胍(观察组)的降压作用明显优于氯沙坦(对照组),P<0.05;②观察组的BMI、WC、血脂水平(TC、TG、HDL-C、LDL-C)及尿酸水平较治疗前显著下降,P<0.05,而单纯的氯沙坦也可降低患者的尿酸水平,P<0.05,但与氯沙坦联合二甲双胍比较,P<0.05。结论 二甲双胍联合氯沙坦对肥胖型高血压合并高尿酸血症患者具有良好的降压效果及改善代谢的作用,能降低BMI、WC、尿酸及血脂水平。

Objective The purpose of this study was to observe the effects of Metformin and Losartan on blood pressure, body mass index （BMI）, Waist Circumference（WC）, uricemia and lipids in obesity associated hypertension and hyperuricemia patients. Methods 70 patients diagnosed as obesity-associated hypertension and hyperuricemia were randomly divided into observation group （35 cases） and control group （35 cases）, observation group were treated with metformin（500mg） ＋Losartan（50mg）~ control group were given Losartan （50mg）, observation period was 24 weeks. Before and after treatment the lipids （TC,, TC, HDL-C, LDL-C） levels, BMI, WC and uricemia changes were measured. Outpatient follow-up every 2 weeks and record blood pressure. Results （~）After 24 weeks treatment, Antihypcrtensive effect of the observation group was significantly better than con^ol group （P〈0.05）~ （~）obscrvation group＇ s BMI, WC, Lipid levels, uricemia decreased significantly compared with before treatment （P〈0.05 or P〈0.01）, while the control group, no significant change compared with before treatment （P〉0.05）. Conclusion Metformin ＋ Losartan in obesity-associated hypertension and hyperuricemia patients not only has good anti-hypertension effects and can reduce the BMI, WC, uricernia and lipid levels.