氯沙坦治疗老年高血压伴高尿酸血症疗效观察

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目的:观察氯沙坦治疗老年轻中度原发性高血压伴高尿酸血症的疗效及不良反应。方法:选择老年轻中度原发性高血压伴高尿酸血症77例,随机分为观察组38例,对照组39例。观察组采用氯沙坦治疗,每次50mg,每天早晨口服1次;对照组采用替米沙坦治疗,每次40mg,每天早晨口服1次。两组均治疗8周。两组治疗4周血压控制未达标(收缩压≥140mmHg或舒张压≥90mmHg)则剂量加倍。结果:两组治疗后收缩压和舒张压均较治疗前显著下降(P<0.01);治疗后观察组收缩压与舒张压为(140.5±13.6)和(78.1±10.6)mmHg,对照组为(133.8±11.5)和(73.2±8.8)mmHg,两组比较差异不显著(P>0.05)。治疗前后,观察组血尿酸水平为(429.56±90.3)μmol/L和(381.9±82.3)μmol/L,对照组为(428.14±88.4)μmol/L和(423.56±83.6)μmol/L,两组比较差异显著(P<0.05)。观察组与对照组分别发生轻微头晕、疲乏、咳嗽、胃肠道不适等不良反应6例(15.8%)和5例(12.8%),两组比较差异不显著(P>0.05)。结论:氯沙坦降低血尿酸作用优于替米沙坦。 Objective: To observe the efficacy and adverse reactions of losartan in the treatment of mild to moderate essential hypertension with hyperuricemia. Methods: A total of 77 elderly patients with mild to moderate essential hypertension with hyperuricemia were randomly divided into observation group (38 cases) and control group (39 cases). The observation group was treated with losartan, each 50mg, taken orally once every morning; the control group treated with telmisartan, each 40mg, taken orally once every morning. Both groups were treated for 8 weeks. Two groups of treatment 4 weeks of blood pressure control did not meet the standard (systolic blood pressure ≥ 140mmHg or diastolic blood pressure ≥ 90mmHg) dose doubled. Results: The systolic pressure and diastolic pressure of both groups after treatment were significantly lower than those before treatment (P <0.01). After treatment, the systolic and diastolic blood pressures in the observation group were (140.5 ± 13.6) and (78.1 ± 10.6) mmHg, respectively 133.8 ± 11.5) and (73.2 ± 8.8) mmHg, respectively. There was no significant difference between the two groups (P> 0.05). Before and after treatment, the level of serum uric acid in the observation group was (429.56 ± 90.3) μmol / L and (381.9 ± 82.3) μmol / L, while the control group was 428.14 ± 88.4 μmol / L and 423.56 ± 83.6 μmol / L, The difference was significant (P <0.05). There were 6 cases (15.8%) and 5 cases (12.8%) of adverse reactions such as mild dizziness, fatigue, cough and gastrointestinal discomfort in observation group and control group respectively. There was no significant difference between the two groups (P> 0.05). Conclusion: losartan is superior to telmisartan in lowering serum uric acid.
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