中老年住院2型糖尿病患者血尿酸水平与胰岛素抵抗的相关性研究北大核心CSCD

目的探讨2型糖尿病患者血尿酸水平与胰岛素抵抗的关系。方法回顾性研究,以728例中老年住院2型糖尿病患者为研究对象。常规测定患者体质指数、腰围、血压、肝肾功能、血尿酸、空腹血糖、糖化血红蛋白（HbA1C）、血脂、空腹C肽等相关临床指标。根据血尿酸水平、代谢综合征发生情况及含有不同组分数目进行分组,分析血尿酸水平与胰岛素抵抗和高尿酸血症与代谢综合征的相关性。结果728例患者中,高尿酸血症发生率为26．9％（196例）,代谢综合征发生率为64．6％（470例）。高尿酸血症组体质指数、腰围、收缩压、舒张压、三酰甘油、空腹C肽及胰岛素抵抗指数（HOMA）（C肽）高于正常尿酸组,而高密度脂蛋白胆固醇（HDL-C）则低于正常尿酸组。高尿酸血症组代谢综合征发生率81．6％（160／196）,高于正常尿酸组（58．3％,310／532）,差异有统计学意义（P〈0．05）。按尿酸水平四分位数分为4组,尿酸水平由低至高含有代谢综合征组分的数目分别为2．1±1．0、3．1±1．1、3．3±1．2、3．7±0．8,对应各组HOMA（C肽）水平、代谢综合征发生率差异有统计学意义（均P〈0．05）。代谢综合征组尿酸水平（377．3±43．5）gmol／L、高尿酸血症发病率（34．0％,160／470）、HOMA（C肽）3．9±0．7,均高于非代谢综合征组（318．2±47．9）μmol／L、14．0％（36／258）、3．6±0．7;按代谢综合征不同组分数目1～5个分5组,各组的血尿酸、HOMA（C肽）水平比较,差异有统计学意义（均P〈0．05）。Pearson相关分析,血尿酸水平与年龄、腰围、体质指数、三酰甘油、收缩压、空腹C肽、HOMA（C肽）呈正相关,与HbA1c、HDL-C呈负相关。多元Logistic回归分析示随着血尿酸水平的升高,代谢综合征的发病风险增加（OR=1．033,95％CI：1．026-1．041,P〈0．05）。结论中老年住院2型糖尿病患者中血尿酸水平与胰岛素抵抗密切相关,高尿酸血症是代谢综合征的危险因素之一。     

2型糖尿病合并高尿酸血症与代谢综合征的相关性研究

目的研究2型糖尿病患者血清尿酸水平在代谢综合征发病中的作用。方法将365例2型糖尿病患者按血清尿酸水平分成两组：高尿酸水平组77例,尿酸水平正常组288例,观察血清尿酸水平与代谢综合征主要组分的相关性。结果血尿酸与血压、甘油三酯、体质指数呈正相关（P〈0．01）,与高密度脂蛋白胆固醇呈负相关（P〈0．01）;高尿酸组代谢综合征患病率为77．92％,尿酸正常组为51．04％（P〈0．01）。结论2型糖尿病患者血尿酸水平与年龄,收缩压,甘油三酯,低密度脂蛋白胆固醇及体质指数多因素相关,提示2型糖尿病高尿酸血症可能是代谢综合征发病的危险因素之一。     

2型糖尿病患者高尿酸血症与代谢综合征的相关性

目的研究血尿酸水平在2型糖尿病患者代谢综合征发病中的作用,探讨其发病机制。方法将219例2型搪尿病患者按血尿酸水平分为高尿酸组39例和正常尿酸（尿酸水平偏低或正常）组180例,观察血尿酸水平与代谢综合征主要参数的相关性。结果血尿酸与血压、TG、BMI正相关（P〈0．01）,与HDL—C呈负相关（P〈0．01）。结论2型糖尿病患者血尿酸水平与多因素相关,2型糖尿病高尿酸血症可能是代谢综合征等发病的危险因素之一。     

冠心病合并代谢综合征患者血浆脂联素和Apelin的水平及临床意义

目的研究冠心病并代谢综合征患者血浆脂肪细胞因子脂联索和Apelin含量的变化及临床意义。方法选择75名住院的冠心病患者,其中合并代谢综合征（MS）者（CM组）35例,单纯冠心病患者（C组）40例,均行冠脉造影检查,并计算相应的Gensini积分;选择同期体检者62例,其中患有MS者（M组）29例,健康者（N组）33例。检测血脂、空腹血糖（FBG）、空腹胰岛素（FIN）、超敏C反应蛋白、游离脂肪酸,Apelin和脂联素;计算BMI、胰岛素抵抗指数（HOMA—IR）并进行比较。结果CM组、c组和M组的患者血浆脂联素和Apelin浓度均低于N组（P均〈0．05）,其中CM组的脂联素较C组和M组低（P〈0．05）,Apelin的水平介于C组和M组之间（P〈0．05）。直线相关分析显示,脂联素与HDL—C显著正相关（P〈0．01）,与超敏C反应蛋白、SBP、DBP、甘油三酯、腰围、BMI（P均〈0．01）和尿酸、FIN、HOMA—IR（P均〈0．05）成负相关;Apelin与HDL—C显著正相关（P〈0．01）,与SBP、DBP、甘油三酯、尿酸、BMI和腰围成负相关（P均〈0．05）。在冠心病患者中,脂联素与Gensini积分呈负相关（P〈0．05）,而Apelin与之无明显相关性（P〉0．05）。结论冠心病并MS患者血浆脂联素水平显著降低,而Apelin的水平介于冠心病和MS之间,其水平更易受代谢成分的影响,不能像脂联素那样较好地反映和评估冠心病伴MS患者的病情严重程度。     

藏族多囊卵巢综合征患者胰岛素抵抗的研究

目的：探讨藏族人群多囊卵巢综合征（POS）与胰岛素抵抗的关系。方法：将30例POS患者的血压、体重指数（BMI）、血脂、血糖和胰岛素水平与30例正常对照组比较。结果：POS患者的BMI（P〈0.01）、血压（P〈0．05）、总胆固醇（P〈0.01）、甘油三酯（P〈0.05）、低密度脂蛋白（P〈0．05）水平高于对照组，高密度脂蛋白（P〈0．0001）低于对照组。空腹胰岛素（P〈0．0001）和餐后2h血糖（P〈0．0001）也高于对照组。POS组的胰岛素抵抗指数（HOMA-IR值）高于对照组（P〈0.01）。结论：藏族POS患者呈现动脉粥样硬化危险因素聚集（肥胖、血脂异常、高血压、高血糖）。     

糖尿病视网膜病变相关因素分析

目的了解糖尿病视网膜病变（DR）的相关因素。方法测定92例代谢综合征（MS）、80例2型糖尿病（DM）患者血糖、糖化血红蛋白（HbA1c）、血脂、C反应蛋白（CRP）、血压、身高、体重,计算体重指数（BMI）。应用免散瞳眼底拍照行眼底筛查。分析DR与年龄、糖尿病及高血压病程、血糖、HbA1c、血脂、BMI的相关性。结果MS组DR发生率高于DM组（P〈0．05）。DR组CRP、餐后2小时血塘、HbA1c、甘油三脂、血压、MS患病率高于非DR组（P均〈0．05）,糖尿病和高血压病程长于非DR组（P均〈0．05）。DR与糖尿病病程和CRP浓度正相关（β=0．250、0．354,P=0．000、0．007）。结论DR与长期高血糖、高血压、脂代谢紊乱及CRP密切相关。     

尿毒症血液透析患者血尿酸与心血管疾病的关系

目的分析维持性血液透析尿毒症患者血尿酸与心血管疾病的关系,探讨血尿酸对心血管系统的影响机制。方法选择维持性血液透析尿毒症患者160例,以血尿酸正常参考值440μmmol／L为分界点分为血尿酸升高组（74例）和血尿酸正常组（86例）。血C反应蛋白（CRP）、肿瘤坏死因子-α（TNF-α）和纤维蛋白原（Fbg）采用ELISA方法测定,全自动生化仪测定血尿酸（UA）、总胆固醇（TC）、甘油三酯（TG）、低密度胆固醇（LDL）和高密度胆固醇（HDL）。心绞痛诊断根据患者的主观症状及疾病发作时的心电图。结果尿酸升高组心绞痛的发生率高于尿酸正常组（P〈0．05）。尿酸升高组的TG、LDL、CRP、Fbg水平均显著高于尿酸正常组（P〈0．05）,而HDL低于尿酸正常组（P〈0．05）。单因素相关分析显示UA与TG、LDL、CRP、TNF-α、Fbg、Scr呈正相关,与HDL呈负相关。结论血尿酸升高加重维持性血液透析患者脂代谢紊乱并诱发炎症因子的产生,与透析患者心血管疾病的发生发展密切相关。     

复方丹参滴丸治疗代谢综合征临床观察

目的观察复方丹参滴丸对代谢综合征患者血黏度、血脂、血糖、胰岛素、尿微量白蛋白、血管性血友病因子（vWF）的影响。方法将患者随机分成两组,治疗组给予复方丹参滴丸10粒口服、3次／d,对照组给予安慰剂口服。疗程3个月,治疗前后分别检测患者血黏度、血脂、空腹血糖及餐后2h血糖（2hPG）和胰岛素、尿微量自蛋白、vWF。结果治疗组的血黏度、HDL—C、2h PG、胰岛素、尿微量白蛋白及vWF较治疗前明显改善,且与对照组治疗后有统计学差异（P〈0．05,或〈0．01）;两组TC、TG、LDL-C、空腹血糖及胰岛素水平元统计学差异（P〉0．05）。结论复方丹参滴丸可改善代谢综合征患者的血黏度、HDL-C、2hPG和胰岛素、尿微量白蛋白及血管内皮功能,可能与其改善胰岛素抵抗有关。     

老年代谢综合征患者血清瘦素水平与胰岛素抵抗的研究

目的：探讨老年代谢综合征患者血清瘦素水平与血糖、血脂、胰岛素和胰岛素抵抗的关系。方法：根据相应的诊断标准，分别收集老年2型糖尿病患者49例，血脂异常患者39例，代谢综合征104例，以同期门诊体检人员49例作为对照组，测定体重指数（BMI）、腰臀比（WHR）、空腹血糖、空腹血清胰岛素（FINS）、空腹血清三酰甘油、瘦素水平等，以稳态模型公式计算胰岛素抵抗指数（HOMA—IR）．并分析瘦素与各参数问的相关性。结果：与正常对照组相比，代谢综合征患者HOMA—IR、血清瘦素水平和FINS均显著增高（t分别为11．849、2．839、3．280，均P〈0．01）。与糖尿病组和血脂异常组相比．代谢综合征组患者的血清瘦素水平（t=3．058，t=2．911，P〈0．01）、FINS（t=2．750，P〈0．01；t=2．482，P〈0．05）和HOMA—IR值（t=3．072，t=7．749，P〈0．01）亦显著增高。直线回归相关分析显示瘦素水平与BMI呈正相关（r=0．418，P〈0．01），校正BMI和性别后与WHR无相关性（r=0．042，P〉0．05），但与FINS、HOMA—IR呈正相关（r：0．257，P〈0．01；r=0．124，P〈0．05）。结论：老年代谢综合征患者中普遍存在高胰岛素血症及胰岛素抵抗：瘦素水平与BMI、FINS及HOMA—IR的相关性提示瘦素是胰岛素抵抗、代谢综合征发生的重要相关因素之一。     

正常高值血压与尿微量白蛋白的关系

目的探讨尿微量白蛋白含量与血压水平的相关性。方法根据《2004年中国高血压防治指南》选择正常高值血压者（≥120／80mmHg）109例及正常血压者（〈120／80m／nHg）49例，测量血压，计算体重指数（BMI），测定空腹血糖（VBS）、血清总胆固醇（CHO）、甘油三酯（TG）、高密度脂蛋白胆固醇（HDL—C）、低密度脂蛋白胆固醇（LDL—C）、尿微量白蛋白（EusA法）等，并做比较。结果正常高值血压组与正常血压组相比，尿微量白蛋白含量升高[（3．08±1．58）mg／L比（3．86±1．7）mg／L，P〈0．01]，CHO、TG、HDL—C和LDL—C两组差异无统计学意义（P〉0．05）。Spearman相关分析显示，尿微量白蛋白与血压、血糖呈正相关，相关系数收缩压r=0．177，P〈0．05；舒张压r=0．252，P=0．001；空腹血糖r=0．279，P〈0．01。校正年龄、性别、血脂、体重指数偏相关分析表明，尿微量白蛋白含量与血压、血糖水平仍呈正相关，相关系数收缩压r=0．156，P=0．055；舒张压r=0．233，P〈0．05；空腹血糖r=0．251，P〈0．05。结论①正常高值血压组尿微量自蛋白水平较高，血糖、体重指数有异常变化，但血脂无异常变化。②尿微量白蛋白发生与舒张压、血糖关系更密切。     

替米沙坦对老年原发性高血压伴代谢综合征血尿酸和超敏C反应蛋白的影响

目的:探讨替米沙坦对老年原发性高血压伴代谢综合征患者,血尿酸和超敏C反应蛋白的影响。方法:将80例老年原发性高血压伴代谢综合征患者分为服用替米沙坦组和硝苯地平控释片组。每组40例,服药6个月,观察用药前、后血尿酸、超敏C反应蛋白、血糖及血脂等代谢指标。结果:替米沙坦组患者经6个月的治疗后的血尿酸及超敏C反应蛋白水平较用药前明显下降,差异有统计学意义(P<0.05);而硝苯地平控释片组治疗后血尿酸及超敏C反应蛋白水平较用药前无明显变化(P>0.05)。结论:替米沙坦降低老年高血压伴代谢综合征患者的血尿酸及炎症因子水平。     

老年高血压和代谢综合征血清脂联素水平变化及其意义

目的:探讨老年高血压和代谢综合症患者血清脂联素水平变化及其意义。方法:60例老年高血压患者、62例老年代谢综合症患者和30例正常老年对照者,检测血压、体重、身高、腰围、空腹血糖、胰岛素、游离脂肪酸、血清脂联素、高敏C反应蛋白、尿素氮、肌酐,计算体重指数,测尿微量蛋白。结果:(1)高血压组和代谢综合症组脂联素水平明显低于正常对照组(P<0.05),体重指数、腹围、尿微量蛋白、游离脂肪酸、血糖、胰岛素、肌酐水平均高于对照组(P<0.05);(2)直线相关分析表明,血清脂联素水平与血压、尿微量蛋白、体重指数、腰围均成负相关(r=-0.230~-0.304,P<0.05~<0.01)。结论:代谢综合症和单纯高血压老年患者脂联素水平降低,且脂联素水平与血压、BMI、腰围及尿微量蛋白呈负相关。     

维吾尔族高血压伴肥胖患者血脂及血尿酸相关性分析

目的：分析维吾尔族原发性高血压伴肥胖患者血脂及血尿酸水平。方法：选择维吾尔族原发性高血压患者124例及维吾尔族非高血压患者116例为研究对象。根据体重指数≥28g／m^2为肥胖,病人被分为高血压伴肥胖组（64例）、高血压无肥胖组（60例）和肥胖无高血压组（57例）、无高血压无肥胖组（59例）,分别测定血清总胆固醇（TC）、甘油三酯（TG）、高密度脂蛋白-胆固醇（HDL-C）、低密度脂蛋白-胆固醇（LDL—C）、载脂蛋白（Apo）-AI、APO-B、血尿酸（UA）浓度。结果：①高血压伴肥胖组血TC、TG、LDL—C、UA浓度较高血压无肥胖组及无高血压无肥胖组显著升高（P〈0．05）;②高血压伴肥胖组血脂、UA浓度与肥胖无高血压组相比无显著差异（P〉0．05）;③高血压无肥胖组TC、LDL—C水平较无高血压无肥胖组显著升高（P〈0．05）;④肥胖无高血压组TC、TG、LDL—C、UA水平较无高血压无肥胖组显著升高（P〈0．05）。结论：维吾尔族原发性高血压伴肥胖患者存在血脂和血尿酸水平升高等代谢紊乱的倾向。     

Serum uric acid in hypertensive patients with and without peripheral arterial disease

BACKGROUND: Uric acid is frequently elevated in hypertension. In addition to renal and metabolic disturbances, lower limb ischemia might contribute to hyperuricemia among hypertensives complicated by peripheral arterial disease (PAD). OBJECTIVE: To test the hypothesis that uric acid status is related to lower limb function in hypertensives with PAD. METHODS: Serum and 24-h urine uric acid levels and other risk factors were examined in 145 hypertensives free of PAD and 166 hypertensives with PAD. Ankle/brachial index (ABI) and absolute claudication distance (in PAD) on a treadmill test (ACD) were assessed. RESULTS: In multiple regression analysis for serum uric acid in the total group, PAD emerged as an independent determinant (P=0.03) next to age (P=0.005), triglycerides (P=0.04), and insulin (P=0.02). Serum uric acid concentrations were higher in hypertensives with PAD (404+/-101 vs. 347+/-80 micromol/l, P<0.001) independent of components of the metabolic syndrome (body mass index, triglycerides, insulin) and of age, gender, diabetes mellitus, pulse pressure, cholesterol, C-reactive protein, and treatment. After adjustment for kidney function by uric acid/creatinine ratio, values remained higher in hypertensives with PAD (P=0.01). Uric acid excretion was higher in the PAD group (P<0.001), whereas uric acid clearance was comparable between both groups. In multiple regression analysis for ACD (357+/-183 m) in the PAD group, serum uric acid (P=0.02), C-reactive protein (P<0.0001), age (P=0.02), and smoking (P=0.004) were independently associated. ABI (0.62+/-0.17) was not related to uric acid in PAD patients. CONCLUSION: Hyperuricemia is more pronounced in hypertensives complicated by PAD and is associated with worse functional status of the peripheral circulation.     

Relationship between serum uric acid concentration and insulin resistance and metabolic syndrome.

BACKGROUND: Associations between hyperuricemia, cardiovascular diseases and diabetes have been reported, but few of the studies have been conducted in the Korean population. The present study examined a Korean adult population with respect to the relationships between serum uric acid concentrations and hypertension, insulin resistance, and the risk factors of metabolic syndrome. METHODS AND RESULTS: A total of 53,477 subjects were divided into 4 groups according to serum uric acid quartiles. The incidence of hypertension in all subjects was higher in the first quartile than in the third plus fourth quartile (odds ratio (OR) 1.192, p < 0.001). Homeostasis model assessment index was found to be associated with serum uric acid concentration in all subjects (OR 1.193, p < 0.001), and the serum uric acid concentration was positively correlated with the risk factors of metabolic syndrome. In addition, the number of metabolic syndrome variables increased as serum uric acid concentration increased. CONCLUSIONS: Serum uric acid concentration was found to be independently correlated with hypertension, insulin resistance and the risk factors of metabolic syndrome. In addition, even those with a serum uric acid concentration in the normal range showed an increased risk of metabolic syndrome as serum uric acid concentration increased.     

健康体检人群血尿酸与非酒精性脂肪肝的相关性研究

目的 观察非酒精性脂肪性肝病(NAFLD)在不同血尿酸水平人群中的分布,以探讨血尿酸与NAFLD的相关性.方法 以本院体检中心5 230名健康体检者为研究对象,测量其身高、体重、血压,空腹取血行肝肾功能、血脂、血糖、肝炎相关指标检查,同时行心电图、腹部超声、胸部X线等检查.NAFLD诊断依据2006年中华肝脏病学会和酒精性肝病学组所规定的NAFLD诊断标准.结果 除高血糖人群外,随血尿酸水平增高,男性和女性超重或肥胖、高血压、血脂异常以及代谢综合征(MS)检出率均逐步升高(P＜0.05或P＜0.01).除男性MS人群外,无论有无超重或肥胖、高血糖、高血压、血脂紊乱,NAFLD检出率均随血尿酸增高明显升高,尤其当血尿酸＞333 μmol/L(男)或＞233 μmol/L(女)时(P＜0.05或P＜0.01),但女性高血糖和血脂紊乱人群,最低尿酸水平组人群NAFLD的检出率亦较高(P＜0.05).对无任何MS相关组分的人群研究发现,在相同血尿酸水平下,男性NAFLD检出率明显高于女性(P＜0.01),女性NAFLD检出率在血尿酸＞233 μmol/L时迅速升高(P＜0.01);无论男女NAFLD检出率均随血尿酸增高而增高(P＜0.05);logistic回归分析显示,性别、体重指数、血糖、甘油三酯、低密度脂蛋白胆固醇、尿酸分级是NAFLD的高危因素,OR值分别为2.500、1.344、1.292、1.279、1.244和1.256.结论 高尿酸血症是NAFLD的高危因素,与NAFLD的发病密切相关.

Abstract：

Objective To evaluate the relationship between hyperuricemia and nonalcoholic fatty liver disease(NAFLD) by observing the prevalence of NAFLD among healthy individuals with different levels of serum uric acid.Methods The data of 5 230 persons from medical centers for health examination were analyzed,such as height,weight,blood pressure,blood lipids,blood sugar, hepatitis-related markers, and abdominal color Doppler ultrasound examination were conducted in the fasting state.The diagnosis of NAFLD was made according to the diagnostic criteria adopted by China Institute of Liver Disease and Alcoholic Liver Disease Group.Results The incidences of overweight or obesity, hypertension,hyperlipidemia, and metabolic syndrome were raised with serum uric acid greater than 333 μmol/L in male and＞233 μmol/L in female subjects(P＜0.05 or P＜0.01). Excluding the metabolic syndrome in male subjects, the incidence of NAFLD was increased with serum uric acid,＞333 μmol/L in males or ＞233 μmol/L in females(P＜0.05 or P＜0.01). In further studies with subjects without any metabolic syndrome, the detection rate of NAFLD was higher in males than in females at the same serum uric acid level(P＜0.01). Logistic regression analysis showed that sex, body mass index, blood glucose, and triglyceride, low-density lipoprotein cholesterol, uric acid grading were risk factors of NAFLD(OR 1.344, 2.500, 1.292, 1.279, 1.244, 1.256 respectively).Conclusion A high serum uric acid level is associated with an increased risk of NAFLD.     

阿法骨化醇对高血压颈动脉粥样硬化患者血尿酸、C反应蛋白和补体的影响

目的观察阿法骨化醇对老年高血压合并颈动脉粥样硬化(CAS)患者血尿酸(BUA)、补体C3和血清C-反应蛋白(CRP)水平的影响。方法随机选择122例老年高血压合并CAS患者分为两组。治疗组:65例患者口服阿法骨化醇加常规药物治疗3月。对照组:57例患者接受常规药物治疗3月。比较治疗前后患者的血压、血糖、血脂、肾功能、CRP、C3和BUA水平的变化。结果阿法骨化醇治疗组患者治疗后CRP、C3和BUA水平明显低于治疗前(P0.05);对照组患者治疗前后CRP、C3和BUA的水平差异无统计学意义(P0.05)。结论阿法骨化醇能够降低老年高血压病合并CAS患者的CRP、C3和BUA水平,可能对防治动脉粥样硬化有着积极的作用。     

Inflammatory biomarkers and oxidative stress measurements in patients with systemic lupus erythematosus with or without metabolic syndrome

The aims of the present study were to report the frequency of metabolic syndrome in systemic lupus erythematosus (SLE); to verify differences in inflammatory biomarkers and oxidative stress in SLE patients with or without metabolic syndrome; and to assess which metabolic syndrome components are associated with oxidative stress and disease activity. The study included 58 SLE patients and 105 controls. SLE patients were divided in two groups, with and without metabolic syndrome. 41.4% patients met the criteria for metabolic syndrome compared with 10.5% controls. Patients with SLE and metabolic syndrome had significantly raised serum uric acid, C-reactive protein (CRP), lipid hydroperoxides, and protein oxidation when compared with patients with SLE without metabolic syndrome. Lipid hydroperoxides were correlated with CRP, whereas protein oxidation was associated with waist circumference and uric acid. There was a positive association between serum C3 and C4 and glucose and between C3 and CRP. SLE disease activity index (SLEDAI) scores were positively correlated with body mass index (BMI) and waist circumference (WC). In conclusion, SLE patients have a high prevalence of metabolic syndrome and this syndrome directly contributes to increase inflammatory status and oxidative stress. Inflammatory processes, being overweight/obese, and uric acid may favor oxidative stress increases in patients with SLE and metabolic syndrome. C3 and C4 may have a positive acute-phase protein behavior in patients with SLE.     

双氢克尿噻治疗盐敏感高血压的疗效观察

目的:观察双氢克尿噻治疗盐敏感高血压的疗效。方法:125例盐敏感高血压患者,按年龄分为青年组、中年组和老年组;按血压水平分为轻度、中度和重度高血压。给予双氢克尿塞12.5 mg口服,2次/d,疗程6周,观察治疗前后各指标的变化。结果:轻中度高血压患者治疗后收缩压(SBP)、舒张压(DBP)显著下降(P<0.01),重度高血压则下降不明显(P>0.05);青年及中年组血压下降明显(P<0.01),老年组下降不明显(P>0.05)。无血糖(Bs)、肌酐(Cr)、尿素氮(BUN)、血钾(K)、血清钠(Na)、血脂三项及血尿酸(UA)等代谢异常。结论:双氢克尿噻能够有效治疗中青年的轻中度盐敏感高血压。     

The effect of analysed hypotensive drugs on certain metabolic parameters

The aim of this study was to assess the influence of 3 hypotensive drugs on the metabolic disorders: dyslipidemia, insulin resistance, hyperuricemia. There were 39 patients aged 20-55, with mild-to-moderate essential hypertension. The patients with other serious diseases or treated earlier with cholesterol or uric acid lowering drugs were excluded. Patients were divided into 3 groups, each was treated during 8 weeks with one drug: gr 1--trandolapril (T), gr 2--felodipine ER (F), gr 3--rilmenidine (R). Glucose and insulin in oral glucose tolerance test, I/G proportion, serum lipids and uric acid were tested before and after therapy. The therapy did not influence lipid parameters: LDL, HDL, triglyceride. In the T group there could be observed a significant reduction of total cholesterol value. Examined drugs did not induce changes in serum carbohydrate. The significant reduction of serum uric acid could be observed only after F therapy. Analysed drugs are very useful in therapy of hypertension with metabolic disorders.