联合降尿酸治疗对原发性高血压患者血压形态的影响
发布时间：2018-11-15 13:29
【摘要】：[目的]联合降尿酸治疗,对伴有高尿酸血症的原发性非杓型高血压患者血压形态的影响。[方法]收集2013年4月至2014年4月于泉州市第一医院住院及门诊临床诊断为高尿酸血症的原发性非杓型高血压(1级或2级)患者136例,其中男性72例,女性64例,平均年龄(61.38±6.79)岁。随机分为降尿酸组(n=68)和对照组(n=68),两组降压均以非洛地平缓释片(波依定)5mg/d治疗;降尿酸组在降压的基础上加用苯溴马隆(尔同舒)50mg/d,共治疗24周。比较两组患者治疗前后血清尿酸水平、动态血压参数以及治疗后两组患者血压达标率、非杓型血压纠正率的差异和血压昼夜差值百分比的差异。[结果]1.血清尿酸水平:治疗后,降尿酸组血清尿酸水平明显降低,与治疗前相比(治疗前466.30±60.39,治疗后344.7±39.86,P0.01),具有显著统计学差异;而对照组的血清尿酸水平(治疗前468.40±60.37,治疗后467.89±60.17,P=0.96),差异无明显统计学意义。2.动态血压结果显示:治疗后,降尿酸组及对照组均能显著降低全天血压。两组白天血压均值及24h血压均值的差异无统计学意义,但是降尿酸组对夜间平均血压的疗效优于对照组(降尿酸组n SBP:122.24±11.72,对照组n SBP:126.99±8.11,P0.01;降尿酸组n DBP:73.66±5.02,对照组n DBP:77.97±3.73,P0.01)。3.治疗后,两组的24h SBP、24h DBP和d SBP、d DBP的达标率(降尿酸组36.76%患者的24h SBP和24h DBP达标,对照组为33.82%,P0.05;降尿酸组30.88%患者的d SBP和d DBP达标,对照组为29.41%,P0.05),差异无统计学意义。但是两组的n SBP和n DBP达标率(降尿酸组60.29%患者的n SBP和n DBP达标,对照组为19.11%,P0.01),差异有显著统计学意义。4.治疗后,降尿酸组将非杓型血压纠正为杓型血压的比例明显上升(降尿酸组为55.88%,而对照组为13.24%,P0.01),差异有显著统计学意义。5.治疗后,降尿酸组的SBP、DBP昼夜差值百分比较对照组有明显的上升(降尿酸组SBP昼夜差值百分比为8.75±7.67,对照组为3.99±6.93,P0.01;降尿酸组DBP昼夜差值百分比为11.59±3.42,对照组为4.58±6.79,P0.01),差异有显著统计学意义。[结论]对于高尿酸血症的原发性非杓型高血压(1级或2级)患者,在降压治疗的基础上联合降尿酸治疗,能够更好地降低夜间血压,并提高夜间血压达标率及杓型血压的比例。
[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 卤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 卤60.39, 344.7 卤39.86, P0.01). But the serum uric acid level of the control group (468.40 卤60.37 before treatment and 467.89 卤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 卤11.72, n SBP:126.99 卤8.11 P 0.01). N DBP:73.66 卤5.02 in hypouric acid group and n DBP:77.97 卤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 卤7.67 in decreasing uric acid group and 3.99 卤6.93 in control group, P 0.01). The percentage of diurnal difference of DBP was 11.59 卤3.42 in hypouric acid group and 4.58 卤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.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R544.1
本文编号：2333439
[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 卤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 卤60.39, 344.7 卤39.86, P0.01). But the serum uric acid level of the control group (468.40 卤60.37 before treatment and 467.89 卤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 卤11.72, n SBP:126.99 卤8.11 P 0.01). N DBP:73.66 卤5.02 in hypouric acid group and n DBP:77.97 卤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 卤7.67 in decreasing uric acid group and 3.99 卤6.93 in control group, P 0.01). The percentage of diurnal difference of DBP was 11.59 卤3.42 in hypouric acid group and 4.58 卤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.
【学位授予单位】：福建医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R544.1
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