氯沙坦与缬沙坦比较治疗原发性高血压合并高尿酸血症的系统评价

目的评价氯沙坦治疗原发性高咀压合并高尿酸血症的临床疗效与安全性。方法电子检索Cochrane图书馆的Cochrane对照试验注册数据库（2008年第4期）、PubMed、MEDLINE、EMBASE、CBM、CNKI、VIP、万方数据资源（截至2008年10月）。由2名评价者按Cochrane协作网推荐的简单评价法独立评价并交叉核对纳入研究的质量，对同质研究采用RevMan5．0软件进行Meta分析。结果共纳入7个RCT，包括1136例病人。Meta分析结果显示：氯沙坦与缬沙坦比较，两者降低诊室收缩压和舒张压及两者副作用发生率的差异无统计学意义；但氯沙坦降尿酸作用明显优于缬沙坦，差异有统计学意义。结论氯沙坦降压和降尿酸有效、安全，其长期疗效、对不同亚组患者作用的差别及其安全性等仍需进行更多高质量的随机对照试验才能得出肯定性结论。

A Systematic Review of Losartan versus Valsartan for Essential Hypertension Associated with Hyperuricemia

Objective To assess the efficacy and safety Losartan for essential hypertension associated with hyperuricemia. Methods Included randomized controlled trials of Losartan versus Valsartan. Electronic search conducted in CENTRAL, the Cochrane Library （until 2008, Issue 4）, PubMed, EMBASE, Chinese Biomedicine database, Chinese Scientific Journals Full-text Database, and China Journal Full-text Database （until 2008, Issue 10）. Two reviewers extracted data independently. RevMan 5.0 software developed by the Cochrane Collaboration was used for Meta- analysis. Results Only 7 trials with 1 136 eligible patients were included in the systematic review. Meta-analysis showed no significant difference in reductions of systolic blood pressure, diastolic blood pressure, and adverse events between Losartan and Valsartan groups. However, a significant difference of serum uric acid reduction was observed between Losartan and Valsartan group. Losartan play a significant role of decreased serum uric acid levels. Condusions Based on this systematic review, Losartan is effective and well tolerated in reducing BP and serum uric acid levels. Further large randomized, double blind, placebo controlled trials are needed in long-term safety and efficacy and different subgroups of Losartan.