摘要
目的评价氯沙坦联合氨氯地平治疗高血压合并高尿酸血症的疗效和安全性。方法本研究系统检索中国生物医学文献数据库、PubMed、中国知网、万方数据知识服务平台、维普网,筛选氯沙坦联合氨氯地平治疗高血压合并高尿酸血症的随机对照试验(randomized controlled trials,RCTs),检索时间范围为各数据库建立之日起至2025年7月,按照既定的纳入与排除标准筛选文献,完成文献筛选后进行数据提取及质量评估,运用RevMan5.3软件开展Meta分析工作。结果共纳入9项RCTs,包括791例患者。Meta分析结果表明,联合用药组降低收缩压的疗效优于氯沙坦组(MD=–10.6,95%CI:–8.87~–12.32,P<0.01);联合用药组降低舒张压的疗效较氯沙坦组更佳(MD=–8.71,95%CI:–9.88~–7.54,P<0.01);联合用药组降低血尿酸水平的疗效明显优于氯沙坦组(MD=–89.74,95%CI:–117.63~–61.85,P<0.01);联合用药组和氯沙坦组的不良反应发生率差异无统计学意义(OR=1.46,95%CI:0.78~2.75,P=0.24)。结论相较于单独应用氯沙坦,当前证据表明氯沙坦联合氨氯地平可更有效降低高血压伴高尿酸血症患者的收缩压、舒张压、血尿酸水平,但受限于本研究纳入文献质量,仍需进行更多高质量的RCTs对本研究无结论加以验证。
Objective To evaluate the efficacy and safety of losartan combined with amlodipine in the treatment of hypertension complicated with hyperuricemia.Methods In this study,the Chinese biomedical literature Metabase,PubMed,CNKI,Wanfang Data Knowledge Service Platform and VIP were searched by computer to find randomized controlled trials(RCTs)of losartan combined with amlodipine in the treatment of hypertension complicated with hyperuricemia.The retrieval time ranged from the date of establishment of each database to July 2025.Literature should be screened according to the established inclusion and exclusion criteria.After completing the literature screening,data extraction and quality assessment should be carried out,and then Meta-analysis should be performed using RevMan5.3 software.Results A total of 9 RCTs were included,involving 791 patients.Meta-analysis showed that combined medication group was superior to losartan group in reducing systolic blood pressure(MD=–10.6,95%CI:–8.87-–12.32,P<0.01).The curative effect of combined medication group on reducing diastolic blood pressure was better than that of losartan group(MD=–8.71,95%CI:–9.88-–7.54,P<0.01);The curative effect of combined medication group in reducing serum uric acid level was significantly better than that of losartan group(MD=–89.74,95%CI:–117.63-–61.85,P<0.01).There was no statistical significance in the incidence of adverse reactions between combination group and losartan group(OR=1.46,95%CI:0.78-2.75,P=0.24).Conclusion The current evidence shows that losartan combined with amlodipine can effectively reduce the systolic blood pressure,diastolic blood pressure and serum uric acid levels in patients of hypertension complicated with hyperuricemia compared with losartan alone,but limited by the quality of the literature included in this study,more high-quality RCTs are still needed to verify the conclusions of this study.
作者
沈婉之
单昕灵
戴森杰
袁一峰
陈轶嘉
SHEN Wanzhi;SHAN Xinling;DAI Senjie;YUAN Yifeng;CHEN Yijia(Second Clinical School of Zhejiang Chinese Medicine University,Hangzhou 310053,Zhejiang,China;Second Affiliated Hospital of Zhejiang Chinese Medicine University,Hangzhou 310005,Zhejiang,China;Zhejiang Provincial Tongde Hospital,Hangzhou 310012,Zhejiang,China)
出处
《中国现代医生》
2025年第36期50-55,共6页
China Modern Doctor
基金
国家自然科学基金(81904083)
浙江省大学生新苗人才计划(732213A13031)。
