老年慢性心力衰竭患者血清尿酸水平变化及氯沙坦的影响

目的探讨充血性心力衰竭（CHF）血清尿酸（UA）水平变化及氯沙坦的影响。方法80例CHF患者随机被分为氯沙坦和依那普利组，观察治疗前后UA变化，并比较CHF患者不同心功能状态下的血清尿酸浓度。结果①CHF患者心功能Ⅰ～Ⅱ、Ⅲ、Ⅳ级者UA分别为（344±105）μmol／L、（417v112）μmol／L、（488±123）μmol／L；心功能Ⅳ级明显高于Ⅰ～Ⅱ级患者（P〈0．01）；②氯沙坦组治疗后UA水平显著降低，（414Ⅰ112）μmol／L、（273±99）μmol／L（P〈0．05）；依那普利组治疗前后无显著差异（P〉0．05）。结论慢性心力衰竭患者UA水平随心功能不全加重而明显升高，氯沙坦在改善心功能同时具有降血清尿酸作用。

Influence of losartan on level of serum uric acid in patients with congestive heart failure

Objective To study the influence of losartan on level of serum （UA） in patients with congestive heart failure （CHF）. Methods The concentrations of serum UA in 80 CHF patients according class of cardiac function were compared. The 80 CHF patients were randomly averagely divided into losartan and enalapril groups . The treatment time of the two groups was 12 weeks. The level of serum UA was examined before and after treatment respectively. Results The concentrations of serum UA in NYHA cardiac function class Ⅰ - Ⅱ,Ⅲ ,Ⅳ was （344 ±105） μmol/L、（417 ± 112） μmol/L、 （488± 123） μmol/L, respectively and The level of serum UA in Ⅳ was much higher than those in class Ⅰ to class Ⅱ （ P 〈 0. 01 ）, The level of serum UA in losartan group before and after treatment was （ 414 ± 112 ） μmol/L, （ 273 ±99 ） μmol/L （ P 〈 0. 05 ）. while the UA level of enalapril group was no significant change （ P 〉 0.05 ）. Conclusion The concentration of serum UA in CHF patients is obviously raise along with the CHF worsened. Losartan can improve cardiac function and has a role of decreasing the serum uric acid.