【摘要】：[目的]聯(lián)合降尿酸治療,對(duì)伴有高尿酸血癥的原發(fā)性非杓型高血壓患者血壓形態(tài)的影響。[方法]收集2013年4月至2014年4月于泉州市第一醫(yī)院住院及門診臨床診斷為高尿酸血癥的原發(fā)性非杓型高血壓(1級(jí)或2級(jí))患者136例,其中男性72例,女性64例,平均年齡(61.38±6.79)歲。隨機(jī)分為降尿酸組(n=68)和對(duì)照組(n=68),兩組降壓均以非洛地平緩釋片(波依定)5mg/d治療;降尿酸組在降壓的基礎(chǔ)上加用苯溴馬隆(爾同舒)50mg/d,共治療24周。比較兩組患者治療前后血清尿酸水平、動(dòng)態(tài)血壓參數(shù)以及治療后兩組患者血壓達(dá)標(biāo)率、非杓型血壓糾正率的差異和血壓晝夜差值百分比的差異。[結(jié)果]1.血清尿酸水平:治療后,降尿酸組血清尿酸水平明顯降低,與治療前相比(治療前466.30±60.39,治療后344.7±39.86,P0.01),具有顯著統(tǒng)計(jì)學(xué)差異;而對(duì)照組的血清尿酸水平(治療前468.40±60.37,治療后467.89±60.17,P=0.96),差異無(wú)明顯統(tǒng)計(jì)學(xué)意義。2.動(dòng)態(tài)血壓結(jié)果顯示:治療后,降尿酸組及對(duì)照組均能顯著降低全天血壓。兩組白天血壓均值及24h血壓均值的差異無(wú)統(tǒng)計(jì)學(xué)意義,但是降尿酸組對(duì)夜間平均血壓的療效優(yōu)于對(duì)照組(降尿酸組n SBP:122.24±11.72,對(duì)照組n SBP:126.99±8.11,P0.01;降尿酸組n DBP:73.66±5.02,對(duì)照組n DBP:77.97±3.73,P0.01)。3.治療后,兩組的24h SBP、24h DBP和d SBP、d DBP的達(dá)標(biāo)率(降尿酸組36.76%患者的24h SBP和24h DBP達(dá)標(biāo),對(duì)照組為33.82%,P0.05;降尿酸組30.88%患者的d SBP和d DBP達(dá)標(biāo),對(duì)照組為29.41%,P0.05),差異無(wú)統(tǒng)計(jì)學(xué)意義。但是兩組的n SBP和n DBP達(dá)標(biāo)率(降尿酸組60.29%患者的n SBP和n DBP達(dá)標(biāo),對(duì)照組為19.11%,P0.01),差異有顯著統(tǒng)計(jì)學(xué)意義。4.治療后,降尿酸組將非杓型血壓糾正為杓型血壓的比例明顯上升(降尿酸組為55.88%,而對(duì)照組為13.24%,P0.01),差異有顯著統(tǒng)計(jì)學(xué)意義。5.治療后,降尿酸組的SBP、DBP晝夜差值百分比較對(duì)照組有明顯的上升(降尿酸組SBP晝夜差值百分比為8.75±7.67,對(duì)照組為3.99±6.93,P0.01;降尿酸組DBP晝夜差值百分比為11.59±3.42,對(duì)照組為4.58±6.79,P0.01),差異有顯著統(tǒng)計(jì)學(xué)意義。[結(jié)論]對(duì)于高尿酸血癥的原發(fā)性非杓型高血壓(1級(jí)或2級(jí))患者,在降壓治療的基礎(chǔ)上聯(lián)合降尿酸治療,能夠更好地降低夜間血壓,并提高夜間血壓達(dá)標(biāo)率及杓型血壓的比例。
[Abstract]:Objective: to study the effect of combined hypouric acid therapy on blood pressure in patients with essential non-dipper hypertension with hyperuricemia. [methods] from April 2013 to April 2014, 136 patients with primary non-dipper hypertension (grade 1 or grade 2) who were clinically diagnosed as hyperuricemia in the first Hospital of Quanzhou, including 72 males and 64 females, were collected. The average age was (61.38 鹵6.79) years. Two groups were randomly divided into two groups: noruric acid group (nong68) and control group (nong68). Both groups were treated with felodipine sustained-release tablets (Boyding) 5mg/d, and those in hypouric acid group were treated with 50 mg / d benzbromarone (Ertongshu) on the basis of hypotension for 24 weeks. The serum uric acid level, ambulatory blood pressure parameters, blood pressure reaching standard rate, non-dipper blood pressure correction rate and diurnal percentage of blood pressure were compared between the two groups before and after treatment. [result] 1. Serum uric acid level: after treatment, the serum uric acid level in the decreasing uric acid group was significantly lower than that before treatment (466.30 鹵60.39, 344.7 鹵39.86, P0.01). But the serum uric acid level of the control group (468.40 鹵60.37 before treatment and 467.89 鹵60.17 P0. 96 after treatment) had no significant difference. 2. The results of ambulatory blood pressure showed that after treatment, the blood pressure of all day was significantly decreased in both the control group and the lower uric acid group. There was no significant difference in daytime and 24h blood pressure between the two groups, but the effect of decreasing uric acid group on nocturnal mean blood pressure was better than that of control group (n SBP:122.24 鹵11.72, n SBP:126.99 鹵8.11 P 0.01). N DBP:73.66 鹵5.02 in hypouric acid group and n DBP:77.97 鹵3.73 in control group (P0.01). After treatment, the 24 h SBP,24h DBP and d SBP,d DBP of the two groups reached the standard (36.76% of the patients in the uric acid group reached the standard of 24 h SBP and 24 h DBP, the control group was 33.82%, P 0.05). D SBP and d DBP reached the standard in 30.88% of the patients in the uric acid group, and 29.41% in the control group (P0.05), the difference was not statistically significant. But n SBP and n DBP reached the standard rate (n SBP and n DBP reached the standard in 60.29% of the patients in the uric acid group and 19.11% in the control group), the difference was statistically significant. 4. After treatment, the proportion of non-dipper blood pressure corrected to dipper blood pressure was significantly increased in hypouric acid group (55.88% in the hypouric acid group, while 13.24% P0.01 in the control group), the difference was statistically significant (P < 0.05). After treatment, the percentage of diurnal difference of SBP,DBP in decreasing uric acid group was significantly higher than that in control group (8.75 鹵7.67 in decreasing uric acid group and 3.99 鹵6.93 in control group, P 0.01). The percentage of diurnal difference of DBP was 11.59 鹵3.42 in hypouric acid group and 4.58 鹵6.79 in control group (P 0.01). [conclusion] in hyperuricemia patients with primary non-dipper hypertension (grade 1 or grade 2), combined hypotensive therapy and hypouric acid therapy can lower nocturnal blood pressure better. The ratio of night-time blood pressure and dipper blood pressure was increased.
【學(xué)位授予單位】：福建醫(yī)科大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2015
【分類號(hào)】：R544.1

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