氯沙坦联用氢氯噻嗪对高血压合并高尿酸血症患者的治疗效果

Effects of combined therapy with losartan and hydrochlorothiazide in hypertensive patients with hyperuricemia

目的:探讨氯沙坦联用氢氯噻嗪对高血压合并高尿酸血症患者血压和血尿酸的影响。方法:入选诊断为原发性高血压合并高尿酸血症,且口服氯沙坦100 mg/d4周以上血压未达标的患者55例,改为每日口服氯沙坦50 mg和氢氯噻嗪12.5 mg复方制剂,共12周。观察药物联合治疗前后患者血压和血尿酸水平的变化。结果:氯沙坦联合氢氯噻嗪治疗后,患者平均收缩压、平均舒张压水平明显下降,分别为(148±11)mmHg对(133±14)mmHg和(91±8)mmHg对(84±9)mmHg(P<0.001),而血尿酸水平无显著变化。结论:对于单用氯沙坦降压效果不显著的高血压合并高尿酸血症患者,氯沙坦联用氢氯噻嗪可明显降低血压水平,且对血尿酸水平无显著影响。

Objective： To evaluate the effects of losartan and hydrochlorothiazide combination therapy on blood pressure and serum uric acid levels in hypertensive patients with hyperuricemia. Methods： A cohort of 55 patients with hypertension and hyperuricemia whose blood pressures uncontrolled with losartan （100 mg/d） for more than 4 weeks were enrolled in this study. All patients were prescribed combination therapy of losartan （50 mg/d） and hydroehlorothiazide （12. 5 mg/d） for 12 weeks. Blood pressures and serum uric acid levels were determined before and after adjustments to the therapy. Results： After losartan and hydrochlorothiazide combination therapy, mean systolic and mean diastolic pressures decreased significantly, which were （ 148 ± 11） mmHg vs. （ 133 ± 14） mmHg and （91 ± 8） mmHg vs. （84 ± 9） mmHg（P〈0. 001）, and no significant change in serum uric acid levels was observed at the end of the treatment. Conclusion： For hypertensive patients with hyperuricemia, combination of losartan and hydrochlorothiazide is more effective in reducing blood pressure than losartan single treatment and has no significant influence on serum uric acid levels.