本文選題：高尿酸血癥 + 碳酸氫鈉��； 參考：《青島大學(xué)》2017年碩士論文

【摘要】：目的:觀察低嘌呤飲食聯(lián)合碳酸氫鈉降尿酸的效果及應(yīng)用后對(duì)血壓及血鈉等的影響。方法:將90例研究對(duì)象按隨機(jī)數(shù)表法隨機(jī)分成A、B、C組,A組低嘌呤飲食作為對(duì)照組,B組低嘌呤飲食聯(lián)合碳酸氫鈉0.5 tid,C組低嘌呤飲食聯(lián)合碳酸氫鈉1.0 tid,應(yīng)用4周后,比較三組血尿酸,尿PH值,診室血壓,動(dòng)態(tài)血壓,血鈉的變化。實(shí)驗(yàn)結(jié)果:1.治療結(jié)束后,A組患者尿酸下降有統(tǒng)計(jì)學(xué)意義(490.93±65.23vs445.36±66.27,P0.05)。B組患者血尿酸變化有統(tǒng)計(jì)學(xué)差異(497.00±73.76vs436.26±68.45,P0.05)。C組患者治療后血尿酸水平較治療前有明顯下降(495.82±71.38vs414.82±54.03)。方差分析結(jié)果示,三組間比較差異有統(tǒng)計(jì)學(xué)意義。兩兩比較結(jié)果顯示,C組降尿酸效果優(yōu)于A組,差異有統(tǒng)計(jì)學(xué)意義,C組與B組比較結(jié)果差異不明顯。2.尿PH值:A組患者尿PH值變化不明顯(5.79±0.91vs6.00±0.39,P0.05)。B組患者尿PH值升高(5.40±0.76vs6.23±0.46,P0.05),差異有統(tǒng)計(jì)學(xué)意義。C組患者尿PH值同樣升高(5.65±0.86vs6.38±0.28,P0.05),且差異有統(tǒng)計(jì)學(xué)意義。3.診室血壓:A組患者治療后診室收縮壓較治療后升高(123.10±14.62vs131.90±11.66,P0.05)。舒張壓前后比較(82.40±9.78vs82.00±7.33,P0.05),無(wú)統(tǒng)計(jì)學(xué)差異。B組患者治療前后診室收縮壓(129.30±10.87vs131.07±10.37,P0.05),差異無(wú)顯著性。治療前后舒張壓(82.70±9.80vs83.13±9.13,P0.05),差異無(wú)統(tǒng)計(jì)學(xué)意義。C組患者治療前后診室收縮壓(125.60±12.82133.10±13.36,P0.05)無(wú)統(tǒng)計(jì)學(xué)差異,治療前后舒張壓(82.60±8.49vs83.00±7.35,P0.05),同樣無(wú)明顯變化。4.24h動(dòng)態(tài)血壓:A組患者治療前后24h動(dòng)態(tài)血壓收縮壓平均值(126.68±12.36vs126.93±11.36,P0.05),差異無(wú)統(tǒng)計(jì)學(xué)意義。治療前后舒張壓平均值(80.99±4.88vs81.10±5.25,P0.05),差異無(wú)統(tǒng)計(jì)學(xué)意義。B組患者治療前后24h動(dòng)態(tài)血壓收縮壓平均值(131.20±9.08vs130.39±8.71,P0.05),無(wú)統(tǒng)計(jì)學(xué)差異。治療前后24h動(dòng)態(tài)血壓舒張壓平均值(82.87±5.79vs82.51±6.47,P0.05),無(wú)統(tǒng)計(jì)學(xué)差異。C組患者治療前后24h動(dòng)態(tài)血壓收縮壓平均值(128.88±12.37vs128.90±11.99,P0.05),差異無(wú)統(tǒng)計(jì)學(xué)意義。治療前后24h舒張壓平均值(81.87±6.23vs82.44±6.44,P0.05),無(wú)統(tǒng)計(jì)學(xué)差異。5.血鈉:三組患者治療前后血鈉均無(wú)明顯變化。(140.64±2.27vs140.57±0.94,140.07±1.71vs140.40±0.99,141.18±2.16vs140.76±1.15,P0.05)。結(jié)論與意義:碳酸氫鈉聯(lián)合低嘌呤飲食能有效降低血尿酸,但其降尿酸程度不足,應(yīng)用劑量需根據(jù)尿PH值進(jìn)行調(diào)整,有效劑量短期內(nèi)應(yīng)用對(duì)血壓、血鈉無(wú)影響。
[Abstract]:Aim: to observe the effect of low purine diet combined with sodium bicarbonate on blood pressure and blood sodium.Methods: ninety patients were randomly divided into two groups: group A, low purine diet, low purine diet and sodium bicarbonate (0.5 tidC), low purine diet and sodium bicarbonate (1.0 tid). After 4 weeks of treatment, serum uric acid was compared among the three groups.Changes of urine PH, blood pressure, ambulatory blood pressure and blood sodium.The result of the experiment was 1: 1.The serum uric acid level in group A was significantly lower than that in group C (490.93 鹵66.27 65.23vs445.36 鹵66.27 65.23vs445.36 鹵66.27) P0.05U. B group after treatment. There was a significant difference in serum uric acid level between group B and group B (497.00 鹵68.45 鹵68.45 鹵68.45). The level of serum uric acid in group C was 495.82 鹵71.38vs414.82 鹵54.03U after treatment.The results of variance analysis showed that the differences among the three groups were statistically significant.The results of pairwise comparison showed that the effect of reducing uric acid in group C was better than that in group A, and there was no significant difference between group C and group B.There was no significant change in urine PH value in group A (5.79 鹵0.39 0.91vs6.00 鹵0.39) P0.05.There was significant difference between group B and group B (5.40 鹵0.76vs6.23 鹵0.46p 0.05), and the difference was statistically significant. Group C also increased the value of urine PH by 5.65 鹵0.86vs6.38 鹵0.28P 0.05, and the difference was statistically significant.The systolic blood pressure (SBP) of group A was 123.10 鹵14.62vs131.90 鹵11.66, P 0.05g after treatment.There was no significant difference in systolic blood pressure between group B and group B (129.30 鹵10.87vs131.07 鹵10.37) before and after treatment, and there was no significant difference between group B and group B (P 0.05).Before and after treatment, diastolic blood pressure (DBP) was 82.70 鹵9.13P0.05g, there was no significant difference between group C and group C. there was no significant difference in systolic blood pressure between group C and group C (125.60 鹵12.82133.10 鹵13.36 P0.05) before and after treatment.Before and after treatment, diastolic blood pressure (DBP) was 82.60 鹵7.35 鹵7.35 鹵P0.05, and there was no significant change. 4.The mean value of 24h ambulatory systolic blood pressure before and after treatment in group A was 126.68 鹵12.36vs126.93 鹵11.36 鹵11.36 (P 0.05), and there was no significant difference.The mean diastolic blood pressure (DBP) before and after treatment was 80.99 鹵4.88vs81.10 鹵5.25g P0.05g. There was no significant difference in the mean value of 24h ambulatory blood pressure (ABP) before and after treatment in group B. there was no statistical difference in the mean value of ambulatory blood pressure before and after treatment (131.20 鹵8.71 鹵8.71 P 0.05).The mean value of ambulatory blood pressure before and after treatment was 82.87 鹵5.79vs82.51 鹵6.47 P0.05, and there was no statistical difference. The mean value of 24h ambulatory blood pressure before and after treatment in group C was 128.88 鹵12.37vs128.90 鹵11.99 P0.05g, and the difference was not statistically significant.The mean value of 24 h diastolic blood pressure before and after treatment was 81.87 鹵6.44 鹵6.44 鹵P 0.05, no significant difference was found between the two groups.Blood natrium: there was no significant change in serum sodium in all the three groups before and after treatment. The blood natrium was 140.64 鹵0.94140.07 鹵1.71vs140.40 鹵0.99141.18 鹵2.16vs140.76 鹵1.15p 0.05g / L before and after treatment.Conclusion and significance: sodium bicarbonate combined with low purine diet can effectively reduce serum uric acid, but the degree of reducing uric acid is insufficient. The dosage of sodium bicarbonate combined with low purine diet should be adjusted according to the PH value of urine. The effective dose has no effect on blood pressure and sodium in the short term.
【學(xué)位授予單位】：青島大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R589.7

【參考文獻(xiàn)】

相關(guān)期刊論文 前9條

1 楊旭東;劉千紅;;不同劑量氯沙坦治療原發(fā)性高血壓合并高尿酸血癥的臨床研究[J];中國(guó)中西醫(yī)結(jié)合腎病雜志;2015年03期

2 劉珠英;曲彩紅;;苯溴馬隆與華法林合用致房顫患者國(guó)際標(biāo)準(zhǔn)化比值升高一例報(bào)告[J];中國(guó)處方藥;2014年09期

3 ;高尿酸血癥和痛風(fēng)治療的中國(guó)專家共識(shí)[J];中華內(nèi)分泌代謝雜志;2013年11期

4 趙慧;陳麗娟;周欣;;氯沙坦和替米沙坦治療高血壓伴高尿酸血癥療效比較[J];齊齊哈爾醫(yī)學(xué)院學(xué)報(bào);2013年16期

5 周繼虎;池振梅;雷鳴;;氯沙坦鉀和賴諾普利對(duì)原發(fā)性高血壓患者腎功能的影響[J];醫(yī)藥論壇雜志;2011年18期

6 劉燕湘;馬萼;梁武;;別嘌醇引起剝脫性皮炎致死亡1例分析[J];中國(guó)藥物警戒;2006年01期

7 吳靜;調(diào)脂藥物的一支獨(dú)秀——非諾貝特的獨(dú)特作用及其臨床應(yīng)用[J];實(shí)用糖尿病雜志;2005年05期

8 姚佳晨,薛佩華;別嘌醇致大皰性表皮萎縮性藥疹死亡一例[J];藥學(xué)服務(wù)與研究;2005年01期

9 曾學(xué)寨,趙迎,李康;華法林鈉合用苯溴馬隆致皮膚、牙齦出血一例[J];中華老年醫(yī)學(xué)雜志;2003年04期

，

本文編號(hào)：1761127