不同剂量氯沙坦治疗原发性高血压合并高尿酸血症的临床研究

Clinical study of different dosages of losartan in the treatment of hypertension with hyperuricemia

目的:探讨不同剂量氯沙坦治疗原发性高血压合并高尿酸血症的效果。方法:2016年6月-2018年5月收治轻、中度原发性高血压合并高尿酸血症患者240例,随机分为A、B、C、D、E和对照组,每组40例。A、B、C、D、E组分别同时给予氯沙坦治疗,剂量分别为50 mg/d、75 mg/d、100 mg/d、125 mg/d、150 mg/d;对照组同时给予氨氯地平5 mg/d。比较各组治疗前后降压、降血尿酸的效果。结果:各组治疗后收缩压、舒张压、血尿酸水平均较治疗前下降;D、E组收缩压、舒张压均明显低于对照组、A组、B组、C组;各组治疗后血尿酸水平为C组、D组、E组<B组<A组<对照组,差异均有统计学意义(P<0.05);各组治疗期间均无心血管事件发生。结论:应用氯沙坦治疗原发性高血压合并高尿酸血症时,增加使用剂量是安全有效的,可较好地控制患者血尿酸水平。

Objective:To explore the effect of different dosages of losartan in the treatment of hypertension with hyperuricemia.Methods:From June 2016 to May 2018,240 patients with mild and moderate essential hypertension and hyperuricemia were selected,and they were randomly divided into the A,B,C,D,E and control group with 40 cases in each group.The A,B,C,D,E group were treated with losartan,the drug dosage was 50 mg/day,75 mg/day,100 mg/day,125 mg/day and 150 mg/day respectively.Amlodipine 5 mg/day was used in the control group.We compared the effect of lowering blood pressure and blood uric acid before and after treatment.Results:Compared with before treatment,the systolic blood pressure,diastolic blood pressure and serum uric acid level of each group decreased after treatment.In group D and E,systolic and diastolic blood pressure were significantly lower than those in control group,group A,group B and group C.The serum uric acid level of each group was C group,D group,E group<B group<A group<control group,and the difference was statistically significant(P<0.05).No cardiovascular events occurred during the treatment in all groups.Conclusion:When losartan is used in the treatment of hypertension with hyperuricemia.It is safe and effective to increase the dosage of losartan,which can better control the level of blood uric acid.