利尿剂对老年高血压患者血压、血钾、尿酸及三酰甘油的影响

The influence of diuretic on blood pressure,serum potassium,uric acid and triacylglycerol in elderly patients with hypertension

目的 探究利尿剂对老年高血压患者血压、血钾、尿酸及三酰甘油的影响,为该病临床治疗积累相关实践性经验.方法 选取本院心内科于2010年1月～2012年12月收治的102例高血压患者,根据服用降压药物的不同进行分组,分为利尿剂组（50例）和非利尿剂组（52例）.同时选取同期来院门诊或复查的老年高血压者（未服用降压药或自行停药1个月以上者）,设为对照组.结果 3组的血压、体质指数、肌酐、TC、HDL-C、LDL-C和LVEF差异无统计学意义（P＞0.05）;利尿剂组、非利尿剂组的收缩压、舒张压均低于对照组（P＜0.05）,利尿剂组的血钾低于非利尿剂组、对照组（P＜0.05）,尿酸和三酰甘油均高于非利尿剂组、对照组（P＜0.05）;继续服用利尿剂组的血钾低于停服利尿剂组,血尿酸高于停服利尿剂组（P＜0.05）.结论 老年高血压患者服用利尿剂与非利尿剂的降压效果相当,但长期服用会增高低血钾、高尿酸及高血脂发生率,因此,医生应指导服用利尿剂患者定期来院检测上述指标,并针对异常数值给予早期干预.

Objective To explore the influence of diuretic on blood pressure,blood potassium, uric acid and triacylglycerol in elderly patients with hypertensive,and accumulating related practical experience of the clinical treatment of disease. Methods 102 cases with hypertension in department of cardiology in our hospital from January 2010 to December 2012 were selected and divided into the diuretic group （n=50） and the non diuretic group （n=52） according the different of antihypertensive drugs applied.At the same time,the elderly patients with hypertension （not taking antihypertensive drugs or to stop the drug on their own for more than 1 month） were selected as the control group. Results There was no statistical difference of blood pressure,body mass index,creatinine,TC,HDL-C,LDL-C and LVEF among the three groups （P〉0.05）;systolic and diastolic blood pressure in the diuretic group and the non diuretic group were lower than those in the control group （P〈0.05）,and blood potassium of the diuretic group was lower than that in the non diuretic group and the control group （P〈0.05）,and uric acid and triglyceride of the diuretic group were higher than those in the non diuretic group and the control group （P〈0.05）;blood potassium of the continue taking the diuretic group was lower than that in the stop taking diuretic group,and blood uric acid of the continue taking the diuretic group was higher than in the stop taking diuretic group （P〈O.05）. Conclusion The hypotensive effect is almost the same of taking diuretics and non diuretic in elderly patients with hypertensive,but the long-term taking can increase the incidence rate of low blood potassium,high uric acid and high blood fat,therefore, the doctor should guide patients taking diuretics to detect regularly the indexes above-mentioned to the hospital,and give early intervention in the abnormal value.