氯沙坦和福辛普利对合并高尿酸血症的高血压左心室肥厚患者疗效的对比研究

Comparative study of efficacy of losartan and fosinopril in treatment of hypertensive left ventricular hypertrophy complicated by hyperuricemia

目的对比研究氯沙坦和福辛普利对合并高尿酸血症的高血压左心室肥厚患者的降压疗效及对左心室肥厚、血尿酸水平的影响。方法选择高血压合并左心室肥厚、高尿酸血症的患者86例,随机分为氯沙坦组44例,福辛普利组42例。分别应用氯沙坦钾片和福辛普利钠片治疗24周后进行疗效评定。结果两组患者治疗前后的血压水平和左心室肥厚指标均有明显下降(P<0.01);氯沙坦组血尿酸水平下降(P<0.05)。结论福辛普利和氯沙坦均能在很好控制血压的同时逆转左心室肥厚,氯沙坦可以降低血尿酸水平,对于同时伴有高尿酸血症的患者是更理想的治疗药物。

Objective To compare the antihypertensive efficacy of losartan and fosinopril for hypertensive left ventricular hypertrophy （LVH） complicated by hyperuricemia and its influence on the left ventricular hypertrophy and blood uric acid levels. Methods Eighty-six patients with primary hypertension complicated by left ventricular hypertrophy and hyperuricemia were randomly divided into the losartan group with 44 patients and the fosinopril group with 42 patients. In the losartan group, losartan potassium tablets were given 50 mg-100 mg/day; In the fosinopril group, fosinopril sodium tablets were given 10 rag-20 mg/day; The efficacy was evaluated after 24 weeks. Results Both the systolic blood pressure and the diastolic blood pressure decreased significantly after the treatment in both groups （P 〈 0.01）; The left ventricular end- diastolic interventricular septum thickness （IVST）, end-diastolic left ventrieular posterior wall thickness （LVPW）, left ventricular weight （LVM）, left ventricular mass index （LVMI） and end-diastolic left ventricular diameter （LVDd） decreased significantly after the treatment （P 〈 0.05）, with no statistically significant differences between the two groups （P 〉 0.05）. In the losartan group, the blood uric acid level decreased significantly （P 〈 0.05）, with statistical difference from the fosinopril group （P 〈 0.05）. Conclusion Both fosinopril and losartan can reverse the left ventricular hypertrophy while controlling the blood pressure and have good patient tolerance. In addition, losartan can reduce the blood uric acid level and is a more ideal drug for patients with left ventricular hypertrophy complicated by hyperurieemia.