氯沙坦、吲哒帕胺单药或联合治疗对血压、血钾和尿酸的影响

Effects of losartan,indapamide alone or combined treatment on blood pressure, s erum potassium and uric acid levels

目的 :观察氯沙坦、吲哒帕胺单药及联合治疗对原发性高血压病人血压、血钾和血尿酸的影响。方法 :60例轻、中度原发性高血压病人 ,男性 3 4例 ,女性 2 6例 ,年龄 (4 6±s9)a,分为 3组 ,每组 2 0例。氯沙坦组服氯沙坦 5 0mg,po,qd ;吲哒帕胺组服吲哒帕胺 2 .5mg ,po,qd;联合治疗组 2药服法同上 ,疗程均为 1 2wk。检测各组治疗前后血压、血钾和尿酸值。结果 :3组治疗后收缩压和舒张压均较治疗前明显降低 (P <0 .0 1 ) ,联合治疗组降压幅度最大 ,1 2wk时收缩压下降(3 .4± 1 .1 )kPa,舒张压下降 (2 .7± 0 .5 )kPa。吲哒帕胺组治疗后血钾值较治疗前降低 ,氯沙坦组血钾上升 ,但均在正常范围之内。吲哒帕胺组血尿酸升高而氯沙坦组则降低 ,与治疗前相比有非常显著意义 (P <0 .0 1 )。联合治疗组治疗前后血钾和血尿酸无明显变化 (P >0 .0 5 )。结论 :氯沙坦有降低血尿酸的作用 ,其与吲哒帕胺联合治疗不仅有协同降压作用 。

AIM: To observe the effects of losartan, indapamide monotherapy and their combi nation on antihypertension, serum potassium and uric acid levels in patients wit h essential hypertension. METHODS: Sixty patients (M 34, F 26; age (46±s 9) a) with mild to moderat e hypertension were divided into three groups. The patients in losartan group ( n=20) were given losartan 50 mg,po, qd for 12 wk. The patients in inda pamide group (n=20) were given indapamide 2.5 mg,po, qd for 12 wk. The pat ients in combined group (n=20) were given both losartan and indapamide that used as described above. The levels of blood pressure, serum potassium and uric acid before and after treatment in three groups were examined. RESULTS: The systolic blood pressure and diastolic blood pressure decreased si gnificantly in three groups (P< 0.01 ), especially in combined group. At 12 wk of tre atme nt, the systolic blood pressure decreased (3.4±1.1) kPa and the diastolic blood pressure decreased (2.7±0.5) kPa in combined group. Its antihypertensive effic acy was superior to either losartan group or indapamide group (P<0.01). Afte r treatment, the levels of serum potassium of indapamide and losartan group were both in no rmal range, but the former was lower than that before treatment and the latter w as higher. The level of serum uric acid elevated in indapamide group and reduced in losartan group. There were significant differences compared with that before treatment (P< 0.01 ). In combined group, the levels of serum potassium an d uric acid did not changed before and after treatment (P>0.05). CONCLUSION: Losartan monotherapy can reduce serum uric acid levels. Combinati on with indapamide not only have better antihypertensive efficacy, but also can offset the hypopotassium and hyperuricemia adverse reactions caused by indapamid e monotherapy.