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目的:探讨降尿酸治疗对伴发无症状高尿酸血症的高血压患者的血压影响。方法:将140例伴发无症状高尿酸血症的高血压患者随机分为降尿酸组(70例)和对照组(70例),降尿酸组在降压治疗基础上联合降尿酸治疗,对照组常规降压治疗。随访8周,观察治疗前后血尿酸水平,并进行24 h动态血压监测,测血压平均值[24 h平均收缩压(24 h SBP)及舒张压(24 h DBP),白昼平均收缩压(dSBP)及舒张压(dDBP),夜间平均收缩压(nSBP)及舒张压(nDBP)]和血压变异性[24 h SBP、24 h DBP、dSBP、dDBP、nSBP及nDBP的标准差(24 hSBPSD、24 h DBPSD、dSBPSD、dDBPSD、nSBPSD、nDBPSD)]。结果:①与治疗前比较,治疗后降尿酸组血尿酸水平下降更明显(P<0.05),对照组无明显差异(P>0.05);治疗后2组平均血压(24 h SBP、24 h DBP、dSBP、dDBP、nSBP、nDBP)及血压变异性指标(24 h SBPSD、24 h DBPSD、dSBPSD、dDBPSD、nSBPSD、nDBPSD)均下降明显(均P<0.05)。②与对照组治疗后比较,降尿酸组治疗后血尿酸水平下降更明显[(350.5±42.3)μmol/L:(478.6±37.1)μmol/L,P<0.05];血压变异性指标中24 h SBPSD[(10.8±1.5):(13.2±1.6)]、dSBPSD[(7.9±1.3):(10.9±1.3)]、nSBPSD[(6.7±1.2):(9.2±1.7)]下降更明显(均P<0.05)。结论:对伴发无症状高尿酸血症的高血压患者,在常规降压治疗的基础上联合降尿酸治疗能进一步改善血压变异性,可能对患者的预后存在有益的影响。
Objective: To investigate the effect of uric acid lowering therapy on blood pressure in hypertensive patients with asymptomatic hyperuricemia. Methods: 140 hypertensive patients with asymptomatic hyperuricemia were randomly divided into normotensive group (n = 70) and control group (n = 70). On the basis of antihypertensive treatment, Group conventional antihypertensive treatment. After 8 weeks of follow-up, the level of serum uric acid was observed before and after treatment, and the ambulatory blood pressure monitoring was performed at 24 hours. Mean blood pressure (24 h SBP, 24 h DBP, dSBP) DDBP, nSBP and nDBP] and blood pressure variability [24 h SBP, 24 h DBP, dSBP, dDBP, nSBP and nDBP standard deviation (24 hSBPSD, 24 h DBPSD, dSBPSD, dDBPSD, nSBPSD, nDBPSD)]. Results: ①Compared with before treatment, serum uric acid level decreased significantly in urate-lowering group after treatment (P <0.05), but there was no significant difference in control group (P> 0.05); mean blood pressure (24 h SBP, 24 h DBP , DSBP, dDBP, nSBP and nDBP) and indexes of blood pressure variability (24 h SBPSD, 24 h DBPSD, dSBPSD, dDBPSD, nSBPSD and nDBPSD) decreased significantly (all P <0.05). ②Compared with the control group, the level of serum uric acid in the uric acid-lowering group was significantly lower than that in the control group [(350.5 ± 42.3) μmol / L, P <0.05]; while in the blood pressure variability index, SBPD [(10.8 ± 1.5) :( 13.2 ± 1.6)], dSBPSD [(7.9 ± 1.3) :( 10.9 ± 1.3)] and nSBPSD [(6.7 ± 1.2) :( 9.2 ± 1.7)] decreased more significantly <0.05). CONCLUSIONS: Hypertensive patients with hypertension associated with asymptomatic hyperuricemia, combined with conventional antihypertensive therapy, can further improve the blood pressure variability and may have a beneficial effect on the prognosis of patients.