氯沙坦对原发性高血压患者血清尿酸及肾小球滤过率的影响_肾小球滤过率名词解释
[摘要] 目的 探讨氯沙坦对原发性高血压患者的降压疗效以及对血清尿酸（UA）及肾小球滤过率（GFR）的影响。 方法 选取原发性高血压患者80例随机分成氯沙坦组（氯沙坦钾片50 mg，40例）和对照组（贝那普利片10 mg，40例）。总疗程共8周，治疗前后分别测血UA水平及肾功能，计算GFR。 结果 两组患者血压与治疗前比较均显著降低（P ＜ 0.05），两组降压效果无显著差异（P ＞ 0.05）。氯沙坦组治疗8周后血清UA水平与治疗前比较显著降低（P ＜ 0.05），与对照组比较差异有统计学意义（P ＜ 0.05）。两组患者治疗8周后GFR均较治疗前显著升高（P ＜ 0.05），但组间比较差异无统计学意义（P ＞ 0.05）。 结论 氯沙坦和贝那普利均有具有良好的降压效果和肾脏保护作用，但氯沙坦在肾脏保护的同时独有降低UA的作用。
[关键词] 原发性高血压；氯沙坦；血清尿酸；肾小球滤过率
[中图分类号] R544.1 [文献标识码] A [文章编号] 1673-7210（2012）07（a）-0082-02
Effects of Losartan on serum uric acid and glomerular filtration rate in patients with essential hypertension
CUI Huifen1 WANG Yuqin1 MENG Jinrong1 WEI Hongsui1 LI Wengang1 WEI Liye2
1.Department of Inner Medicine, Li County Hospital in Baoding City, Hebei Province, Li County 071400, China; 2.the First Hospital of Hebei Medical University, Hebei Province, Shijiazhuang 050031, China
[Abstract] Objective To investigate the effect of Losartan on serum uric acid (UA) and glomerular filtration rate (GFR) in patients with essential hypertension. Methods 80 patients with essential hypertension were randomly divided into Losartan group (Losartan 50 mg, 40 cases) and control group (Benazepril 10 mg, 40 cases). Total treatment duration was 8 weeks, serum uric acid levels and renal function were measured before and after treatment, and the glomerular filtration rate was calculated. Results The level of blood pressure of two groups were significantly lower than before treatment (P ＜ 0.05), the antihypertensive effect in the two groups were not significant different (P ＞ 0.05). After 8 weeks of treatment, serum UA levels of Losartan group were significantly lower than before treatment (P ＜ 0.05), and compared with the control group, the difference was significant (P ＜ 0.05). After 8 weeks treatment, GFR than those before treatment of all the patients were significantly increased (P ＜ 0.05), but there were no significant differences between the two groups (P ＞ 0.05). Conclusion Losartan and Benazepril all have a good antihypertensive and renal protective effect, but Losartan can reduce the uric acid.
[Key words] Essential hypertension; Losartan; Serum uric acid; Glomerular filtration rate
高血压病可引起心、脑、肾等靶器官的损害，从而导致严重的并发症，长期的高血压以及血压波动都可加重动脉粥样硬化，另有研究表明尿酸（UA）也参与了动脉粥样硬化的进程[1-2]。高血压患者中约有三分之一伴有高尿酸血症，而且高尿酸也是心脑血管疾病的独立危险因素之一。因此，降压的同时重视靶器官保护，降低尿酸十分重要。本研究旨在探讨氯沙坦对原发性高血压患者的降压疗效以及对血清尿酸及肾小球滤过率（GFR）的影响。
1 资料与方法
1.1 一般资料
选取河北省保定市蠡县医院门诊或住院符合2005年中国高血压诊治指南标准的原发性高血压患者80例，其中，男37例，女43例，平均年龄（60.5±5.4）岁。所有病例均排除肝功能不全、继发性高血压、糖尿病、高脂血症、痛风、扩张型心肌病、心力衰竭以及服用利尿剂、急慢性肾病的患者。将以上所有符合条件的受试者随机分成氯沙坦组和对照组。氯沙坦组40例，其中，男19例，女21例；年龄57～65岁，平均62.4岁。对照组40例，其中，男18例，女22例；年龄55～66岁，平均64.6岁。两组年龄、性别、病程等差异无统计学意义（P ＞ 0.05），具有可比性。所有受试者治疗前均停服其他降血压药2周。