老年高血压患者利尿剂的使用及其对血钾和尿酸的影响

目的探讨老年高血压患者利尿剂的使用及其对血钾和尿酸的影响。方法选择年龄≥70岁的高血压患者713例,根据入选时患者服用降压药物的情况,分为3组:利尿剂组332例、非利尿剂组270例和未用药组111例,测定血钾、尿酸和其他生化指标,并进行比较。结果利尿剂组和非利尿剂组患者血压显著低于未用药组(P0.05)。与未用药组和非利尿剂组比较,利尿剂组患者尿酸、TG明显升高,血钾明显降低,差异有统计学意义(P0.05,P0.01)。利尿剂组低钾血症发生率明显高于非利尿剂组和未用药组(18.1% vs 10.4% vs 9.9%,P0.05,P0.01)。结论老年高血压患者中,使用利尿剂控制血压与使用非利尿降压药效果相似,但血钾水平低、低钾血症发生率高,血清尿酸升高;长期使用需注意血钾降低的防治。

Use of diuretic and its influence on serum potassium and uric acid in elderly hypertensive patients

Objective To investigate the use of diuretic and its influence on serum potassium and uric acid in elderly hypertensive patients.Methods 713 elderly hypertensive patients aged from 70 to 93 were divided into 3 groups according to the antihypertensive treatment when they entered the study:diuretic group,non-diuretic group and non-treated group.Serum potassium level and other biochemical parameters were determined for all patients.Results The average blood pressure in diuretic group and non-diuretic group was lower than that in non-treated group (P < 0.05).Serum potassium level was evidently lower,while serum uric acid and TG were higher in diuretic group than in non-diuretic group (P < 0.01) or non-treated group (P < 0.05) ,but no significant difference between non-diuretic group and non-treated group (P > 0.05).The incidence of hypokalemia in diuretic group was 18.1%,which was higher than that in non-diuretic group(10.4%) and non-treated group(9.9% ,P < 0.05 ,P < 0.01).Serum concentrations of uric acid and TG were evidently higher in diuretic group than in non-diuretic group (P < 0.05) or non-treited group (P <0.05),but the difference between non-diuretic group and non-treated group had no statistical significance (P > 0.05).Conclusion The present study demonstrated that about 46.5% elderly hypertensive patients used diuretics,and its antihypertensive efficacy was similar to other antihypertensive medicine.However the incidence of hypokalemia was increased in patients who took diuretics.