Benzbromarone combined with sodium bicarbonate in the treatment of hyperuricemia complicated with primary hypertension
-
摘要:
目的 探讨苯溴马隆联合碳酸氢钠治疗高尿酸血症合并原发性高血压的临床疗效。 方法 选择高尿酸血症伴原发性高血压患者126例，按照随机数字表方法分为A组、B组和C组，各42例。A组为苯溴马隆给药组，B组为碳酸氢钠给药组，C组为苯溴马隆加碳酸氢钠给药组。比较治疗前后3组患者的的血肌酐、血尿酸（UA）、24 h尿UA、尿素氮、甘油三酯、24 h平均收缩压与舒张压等指标的变化。 结果 治疗5周后，3组患者的血UA、24 h收缩压与舒张压均低于治疗前（P<0.05），尿UA高于治疗前（P<0.05）；且治疗后C组患者的血UA、24 h平均收缩压与舒张压低于A组和B组（P<0.05），尿UA高于A组和B组（P<0.05），以上均差异有统计学意义。 结论 苯溴马隆联合碳酸氢钠治疗高尿酸血症合并原发性高血压，能有效降低患者的血UA、24 h平均收缩压和舒张压，增加尿UA的排泄，临床效果显著，值得推广应用。 Abstract:Objective To investigate the clinical efficacy of benzbromarone combined with sodium bicarbonate in the treatment of hyperuricemia complicated with primary hypertension. Methods A total of 126 patients with hyperuricemia and primary hypertension were enrolled .The patients were divided into group A, B and C with 42 cases in each group according to random number table method. Patients in group A were treated with benzbromarone, group B were treated with sodium bicarbonate and group C were treated with benzbromarone and sodium bicarbonate. The changes of serum creatinine, serum uric acid (UA), 24 h urine UA, urea nitrogen, triglyceride, 24 h mean diastolic and systolic blood pressure were compared between the before and after treatment of patients in three groups. Results After a 5-week-treatment, serum UA, 24 h mean systolic and diastolic blood pressure of patients in 3 groups were lower than that before treatment (P<0.05).Urine UA was higher than that before treatment (P<0.05). Blood UA, 24 h mean systolic and diastolic blood pressure in patients of group C were lower than those of group A and group B (P<0.05) and urine UA was higher than that of group A and group B (P<0.05). Conclusion Benzbromarone combined with sodium bicarbonate can reduce blood UA, 24 h mean systolic and diastolic blood pressure and increased urine UA excretion in the treatment of patients undergoing hyperuricemia complicated with primary hypertension. The combination therapy have significant clinical effects.It is worthy of popularization in clinical application. -
Key words:
- benzbromarone /
- sodium bicarbonate /
- hyperuricemia /
- primary hypertension
-
表 1 3组患者基本资料比较（n=42,
$\bar x \pm s$ ）组别 年龄（岁） BMI 24 h收缩压（mm Hg） 24 h舒张压（mm Hg） 甘油三酯（mmol/L） 尿素氮（mmol/L） 血肌酐（mmol/L） 血UA（μmol/L） 24 h尿UA（μmol/L） A组 47.5±17.9 25.8±4.8 136.82±6.21 86.90±6.02 2.37±0.92 6.09±1.52 72.18±8.24 534.44±33.12 2976.12±308.65 B组 47.2±17.1 26.2±5.5 136.75±5.92 86.52±5.90 2.32±0.87 5.98±1.34 74.52±7.85 523.98±35.56 3028.67±345.64 C组 47.9±18.2 26.5±5.4 137.03±7.15 86.73±5.20 2.27±0.92 6.08±1.72 75.52±8.51 542.24±31.90 3007.54±327.78 
下载: 导出CSV
表 2 3组患者治疗前后血压、其他生化指标比较（n=42,
$\bar x \pm s$ ）组别 时间 24 h平均收缩压（mm Hg） 24 h平均舒张压（mm Hg） 甘油三酯（mmol/L） 尿素氮（mmol/L） 血肌酐（μmol/L） A组 治疗前 136.94±6.15 86.12±5.97 2.26±0.82 5.89±1.22 73.75±8.16 治疗后 129.94±5.95a 83.12±5.89a 2.37±0.91 5.95±1.31 73.18±7.96 B组 治疗前 136.56±6.12 86.54±5.72 2.27±0.98 6.05±1.37 74.52±8.05 治疗后 136.96±7.12b 86.81±6.00b 2.32±0.92 5.98±1.34 73.92±7.85 C组 治疗前 136.78±5.98 86.17±6.02 2.29±0.87 5.98±1.53 75.52±8.51 治疗后 130.73±6.05a 83.17±5.92a 2.36±0.96 6.00±1.42 74.56±8.41 aP<0.05 vs 干预前; bP<0.05 vs C组.
下载: 导出CSV
表 3 3组患者治疗前后血UA及尿UA指标比较（n=42,
$\bar x \pm s$ ）组别 血UA（μmol/L） 24 h尿UA（μmol/L） 治疗前 治疗后 治疗前 治疗后 A组 536.46±31.92 398.67±26.32a, b 2988.67±348.65 3956.62±398.87a, b B组 538.05±31.52 402.10±30.64a, b 3012.66±365.77 4021.56±421.32a, b C组 534.75±30.86 363.27±29.81a 3029.88±356.82 4266.67±412.38a aP<0.05 vs 干预前; bP<0.05 vs C组.
下载: 导出CSV
-
[1] 张明峰, 郭惠芳, 高丽霞. 高尿酸血症对代谢综合征和心血管病的影响与防治[J]. 临床荟萃, 2016, 31(5): 496-500. http://www.cnki.com.cn/Article/CJFDTOTAL-LCFC201605010.htm [2] Viazzi F, Garneri D, Leoncini G, et al. Serum uric acid and its relationship with metabolic syndrome and cardiovascular risk profile in patients with hypertension: Insights from the I-DEMAND study[J]. Nutr Metab Cardiovasc Dis, 2014, 24(8): 921-7. doi: 10.1016/j.numecd.2014.01.018 [3] Kuo CF, See LC, Yu KH, et al. Significance of serum uric acid levels on the risk of all-cause and cardiovascular mortality[J]. Rheumatology, 2013, 52(1): 127-34. doi: 10.1093/rheumatology/kes223 [4] 赵义发, 徐中林. 降尿酸治疗对伴发无症状高尿酸血症的高血压患者血压的影响[J]. 重庆医学, 2014(32): 4326-8. doi: 10.3969/j.issn.1671-8348.2014.32.017 [5] 曹 雯, 陈国芳, 刘 超. 别嘌呤醇还是苯溴马隆: 降尿酸药物的选择之辩[J]. 药品评价, 2016, 13(15): 5-8, 26. doi: 10.3969/j.issn.1672-2809.2016.15.001 [6] 陈坤顺, 沈国荣, 余红英. 碳酸氢钠治疗高尿酸血症200例临床分析[J]. 医学信息, 2013(27): 469-469. http://www.cnki.com.cn/Article/CJFDTOTAL-YYGZ201702016.htm [7] Hodgin JB, Berthier CC, John R, et al. The molecular phenotype of endocapillary proliferation: novel therapeutic targets for IgA nephropathy[J]. PLoS One, 2014, 9(8): e103413. doi: 10.1371/journal.pone.0103413 [8] 魏晓楠. 非诺贝特和苯溴马隆联合治疗高尿酸血症的有效性对比观察[J]. 中外医疗, 2013, 32(7): 108, 110. http://www.cnki.com.cn/Article/CJFDTOTAL-HZZZ201307074.htm [9] 杨江华, 王 伟. 吡嗪酰胺化疗对肺结核患者血尿酸水平的影响及苯溴马隆的干预治疗[J]. 安徽医药, 2016, 20(2): 384-5, 386. http://www.cnki.com.cn/Article/CJFDTOTAL-AHYY201602054.htm [10] 车嘉韦, 奚啸风. 非布司他与小剂量苯溴马隆治疗高尿酸血症的对比研究[J]. 中国医院用药评价与分析, 2016, 16(12): 1644-5, 1646. http://www.cnki.com.cn/Article/CJFDTOTAL-YYPF201612023.htm [11] 李海昌, 温成平, 谢志军. 痰湿体质与痛风及高尿酸血症的相关性探讨[J]. 中华中医药学刊, 2013, 31(4): 85. http://www.cnki.com.cn/Article/CJFDTOTAL-ZYHS201304050.htm [12] Kansui Y, Ohtsubo T, Goto K, et al. Association of serum uric acid with blood pressure in Japanese men - Cross-Sectional study in Work-Site group[J]. Circ J, 2011, 75(12): 2827-32. doi: 10.1253/circj.CJ-11-0592 [13] Yang T, Chu CH, Bai CH, et al. Uric acid concentration as a risk marker for blood pressure progression and incident hypertension: a Chinese cohort study[J]. Metabolism, 2012, 61(12): 1747-55. doi: 10.1016/j.metabol.2012.05.006 [14] Sánchezlozada LG, Tapia E, Santamaría J, et al. Mild hyperuricemia induces vasoconstriction and maintains glomerular hypertension in normal and remnant kidney rats[J]. Kidney Int, 2005, 67(1): 237-47. doi: 10.1111/j.1523-1755.2005.00074.x [15] Chonchol M, Shlipak MG, Katz R, et al. Relationship of uric acid with progression of kidney disease[J]. Am J Kidney Dis, 2007, 50(2): 239-47. doi: 10.1053/j.ajkd.2007.05.013 [16] 郭健英, 何永成, 廖 莹, 等. 泼尼松联合碳酸氢钠与别嘌呤醇治疗IgA肾病合并高尿酸血症的临床效果观察[J]. 安徽医药, 2016, 20(5): 980-2. http://www.cnki.com.cn/Article/CJFDTOTAL-AHYY201605052.htm [17] Feig DI, Soletsky B, Johnson RJ. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension: a randomized trial[J]. JAMA, 2008, 300(8): 924-32. doi: 10.1001/jama.300.8.924 [18] 封 锐, 胡元会. 老年高血压病人尿酸水平与肾功能损伤及RAAS系统相关性研究[J]. 中西医结合心脑血管病杂志, 2017, 15(1): 11-3. http://www.cnki.com.cn/Article/CJFDTOTAL-ZYYY201701003.htm [19] 赵 娟, 张卓莉. 高尿酸血症与肾损害[J]. 中国医学前沿杂志: 电子版, 2014, 6(10): 8-10. http://cdmd.cnki.com.cn/Article/CDMD-10026-1014242240.htm -
点击查看大图
表(3)
计量
- 文章访问数: 1584
- HTML全文浏览量: 293
- PDF下载量: 5
- 被引次数: 0
