碳酸氢钠对高尿酸血症患者血压及血钠影响的临床观察

发布时间：2018-04-16 23:40

本文选题：高尿酸血症 + 碳酸氢钠　；参考：《青岛大学》2017年硕士论文

【摘要】：目的:观察低嘌呤饮食联合碳酸氢钠降尿酸的效果及应用后对血压及血钠等的影响。方法:将90例研究对象按随机数表法随机分成A、B、C组,A组低嘌呤饮食作为对照组,B组低嘌呤饮食联合碳酸氢钠0.5 tid,C组低嘌呤饮食联合碳酸氢钠1.0 tid,应用4周后,比较三组血尿酸,尿PH值,诊室血压,动态血压,血钠的变化。实验结果:1.治疗结束后,A组患者尿酸下降有统计学意义(490.93±65.23vs445.36±66.27,P0.05)。B组患者血尿酸变化有统计学差异(497.00±73.76vs436.26±68.45,P0.05)。C组患者治疗后血尿酸水平较治疗前有明显下降(495.82±71.38vs414.82±54.03)。方差分析结果示,三组间比较差异有统计学意义。两两比较结果显示,C组降尿酸效果优于A组,差异有统计学意义,C组与B组比较结果差异不明显。2.尿PH值:A组患者尿PH值变化不明显(5.79±0.91vs6.00±0.39,P0.05)。B组患者尿PH值升高(5.40±0.76vs6.23±0.46,P0.05),差异有统计学意义。C组患者尿PH值同样升高(5.65±0.86vs6.38±0.28,P0.05),且差异有统计学意义。3.诊室血压:A组患者治疗后诊室收缩压较治疗后升高(123.10±14.62vs131.90±11.66,P0.05)。舒张压前后比较(82.40±9.78vs82.00±7.33,P0.05),无统计学差异。B组患者治疗前后诊室收缩压(129.30±10.87vs131.07±10.37,P0.05),差异无显著性。治疗前后舒张压(82.70±9.80vs83.13±9.13,P0.05),差异无统计学意义。C组患者治疗前后诊室收缩压(125.60±12.82133.10±13.36,P0.05)无统计学差异,治疗前后舒张压(82.60±8.49vs83.00±7.35,P0.05),同样无明显变化。4.24h动态血压:A组患者治疗前后24h动态血压收缩压平均值(126.68±12.36vs126.93±11.36,P0.05),差异无统计学意义。治疗前后舒张压平均值(80.99±4.88vs81.10±5.25,P0.05),差异无统计学意义。B组患者治疗前后24h动态血压收缩压平均值(131.20±9.08vs130.39±8.71,P0.05),无统计学差异。治疗前后24h动态血压舒张压平均值(82.87±5.79vs82.51±6.47,P0.05),无统计学差异。C组患者治疗前后24h动态血压收缩压平均值(128.88±12.37vs128.90±11.99,P0.05),差异无统计学意义。治疗前后24h舒张压平均值(81.87±6.23vs82.44±6.44,P0.05),无统计学差异。5.血钠:三组患者治疗前后血钠均无明显变化。(140.64±2.27vs140.57±0.94,140.07±1.71vs140.40±0.99,141.18±2.16vs140.76±1.15,P0.05)。结论与意义:碳酸氢钠联合低嘌呤饮食能有效降低血尿酸,但其降尿酸程度不足,应用剂量需根据尿PH值进行调整,有效剂量短期内应用对血压、血钠无影响。
[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 卤66.27 65.23vs445.36 卤66.27 65.23vs445.36 卤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 卤68.45 卤68.45 卤68.45). The level of serum uric acid in group C was 495.82 卤71.38vs414.82 卤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 卤0.39 0.91vs6.00 卤0.39) P0.05.There was significant difference between group B and group B (5.40 卤0.76vs6.23 卤0.46p 0.05), and the difference was statistically significant. Group C also increased the value of urine PH by 5.65 卤0.86vs6.38 卤0.28P 0.05, and the difference was statistically significant.The systolic blood pressure (SBP) of group A was 123.10 卤14.62vs131.90 卤11.66, P 0.05g after treatment.There was no significant difference in systolic blood pressure between group B and group B (129.30 卤10.87vs131.07 卤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 卤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 卤12.82133.10 卤13.36 P0.05) before and after treatment.Before and after treatment, diastolic blood pressure (DBP) was 82.60 卤7.35 卤7.35 卤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 卤12.36vs126.93 卤11.36 卤11.36 (P 0.05), and there was no significant difference.The mean diastolic blood pressure (DBP) before and after treatment was 80.99 卤4.88vs81.10 卤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 卤8.71 卤8.71 P 0.05).The mean value of ambulatory blood pressure before and after treatment was 82.87 卤5.79vs82.51 卤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 卤12.37vs128.90 卤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 卤6.44 卤6.44 卤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 卤0.94140.07 卤1.71vs140.40 卤0.99141.18 卤2.16vs140.76 卤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.
【学位授予单位】：青岛大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589.7

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