中国临床药学杂志

目的观察别嘌呤醇对老年高尿酸血症患者血压的影响并探讨其可能机制。方法选择原发性高尿酸血症伴高血压的老年患者105例,分为别嘌呤醇组(低嘌呤饮食+别嘌呤醇100 mg,bid)56例和对照组(低嘌呤饮食)49例,观察周期12周。观察前后测诊室血压(BP),并采血测空腹血糖(FBG)、三酰甘油(TG)、胆固醇(I℃)、肌酐(Cr)、尿素氮(BUN)、高敏C-反应蛋白(hsCRP)、尿素(UA)、肾素(Renin)、血管紧张素Ⅱ(AngⅡ)和肝功能,观察各项指标的变化并监测药物的不良反应。结果别嘌呤醇组患者12周后与治疗前比较,在UA、BP、hsCRP、Renin、AngⅡ水平等方面均显著下降(P<0.01);对照组除UA水平降低外(P<0.05),在其他方面无变化。在别嘌呤醇应用中,有1例患者出现轻度肝功能损害,另1例患者出现皮疹。结论别嘌呤醇可以降低原发性高尿酸血症伴高血压老年患者的血UA;在降低UA的同时,可以引起血压下降。

AIM To observe the influence of allopurinol on the blood pressure in elderly patients with hyperuricemia and to investigate its mechanism.METHODS A total of 105 elderly patients with essential hyperuricemia and hypertention were involved into this study.A total of 56 patients were in allopurinol group,given allopurinol 100 mg,bid in addition to a low-purine diet for 12 weeks;another 49 patients were in control group,with a low-purine diet for 12 weeks.Clinical blood pressure,fasting blood glucose,triglyceride,total cholesterol,creatinine,urea nitrogen,high-sensitivity C-reactive protein(hsCRP),uric acid,renin,AngⅡand liver function were measured at baseline and at the end of study,and the adverse drug reactions were also observed.RESULTS The level of uric acid,clinical blood pressure, hsCRP,renin and AngⅡwere decreased after 12 weeks in allopurinol group compared with baseline(P<0.01). Control group had no changes except the level of uric acid(P<0.05).The damage of liver occurred in one patient,and the skin rash in another.CONCLUSION Allopurinol can reduce the level of uric acid as well as blood pressure in the elderly patients with essential hyperuricemia and hypertension.