别嘌醇治疗原发性高血压合并高尿酸血症临床分析

目的研究别嘌醇对原发性高血压合并高尿酸血症患者的治疗效果。方法入选60例初发的原发性1级高血压合并高尿酸血症患者,随机、双盲分为别嘌醇组（别嘌醇100 mg,3次/d）和对照组（安慰剂1片,3次/d）,各30例。4周后观察诊室血压、24 h动态血压（ABPM）、血尿酸、血尿常规及肝肾功能,记录症状和体征。结果4周末,别嘌醇组诊室收缩压和舒张压较用药前下降（12.4±5.5）mm Hg（1 mm Hg=0.133 kPa）和（8.4±3.8）mm Hg,差异有统计学意义（P〈0.05）,对照组下降（6.0±2.6）mm Hg和（4.8±1.8）mm Hg,差异无统计学意义（P〉0.05）,两组间比较差异有统计学意义（P〈0.05）;别嘌醇组24 h平均收缩压和舒张压下降（8.6±3.8）mm Hg和（5.2±1.7）mm Hg,差异有统计学意义（P〈0.05）,对照组下降（3.4±1.6）mm Hg和（2.8±0.5）mm Hg,差异无统计学意义（P〉0.05）,两组间24 h平均收缩压和舒张压差值以及血压负荷值比较,差异均有统计学意义（P〈0.05）;两组在降低尿酸方面比较,差异亦有统计学意义（P〈0.05）。两组患者治疗前后均未发现明显副作用。结论别嘌醇在有效降低血尿酸的同时,能够降低血压,可以成为高血压治疗的一个新方法。

Clinical analysis of Allopurinol in the treatment of primary hypertension complicated with hyperuricemia

Objective To analyze the effect of Allopurinol in the treatment of patients with primary hypertension complicated with hyperuricemia.Methods 60 cases newly diagnosed to be with mild primary hypertension complicated with hyperufieemia but never treated were randomly divided into Allopurinol group and control group,with 30 eases in each group.The patients in Allopurinol group took Allopurinol 100 mg,3 times a day,for 4 weeks,while the patients in control group took placebo 1 pill,3 times a day,for 4 weeks.At the end of 4 weeks,the clinical blood pressure 24-hour ambulatory blood pressure（ABPM）,serum uric acid,blood and urine routine,hepatic and renal function were detected,and the symptoms and physical signs were recorded.Results At the end of the 4 weeks,compared with treatment before,the SBP and DBP of the patients in Allopurinol group dropped down（12.4±5.5） mm Hg and（8.4±3.8） mm Hg,with significant differences（P 0.05）,while those of the patients in control group dropped down（6.0±2.6） mm Hg and（4.8±1.8） mm Hg,without significant differences（P 0.05）;the difference of blood pressure decrease was significant between the two groups（P 0.05）.The 24-hour average SBP and DBP decrease in Allopurinol group was（8.6±3.8） mm Hg and（5.2±1.7） mm Hg,with significant differences（P 0.05）,while that in control group was（3.4±1.6） mm Hg and（2.8±0.5） mm Hg,without significant differences（P 0.05）;the differences of 24-hour average SBP and DBP decrease and blood pressure load between the two groups were significant different（P 0.05）;there was also a significant difference of the two groups in decreasing serum uric acid level（P 0.05）.There were no severe adverse effects of the two groups before and after treatment.Conclusion Allopurinol can effectively decrease blood pressure when applied in decreasing serum uric acid,which can be a new way for the treatment of hypertension.