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该研究比较单剂量噻嗪类利尿剂西氯他宁(cicletanine)和氢氯噻嗪(hydrochlorothiazide)对正常高值血压者和未治疗的1级高血压患者尿钠、钾排泄量的影响以及探讨G蛋白耦联受体激酶4(GRK4)基因多态性对噻嗪类利尿剂诱导的尿电解质排泄的影响。本研究是一项对24例男性患者进行的随机、双盲、安慰剂对照、3阶段、4种不同治疗(安慰剂、氢氯噻嗪25mg、西氯他宁50和150mg,n=6)的平衡不完全区组交叉研究。收集3阶段给药前和治疗结束后24h尿液样本,比较各组尿电解质排泄指标的变化。另外,研究人群中,GRK4等位基因变异数<3和≥3个的患者例数相同(n=12)。与安慰剂比较,氢氯噻嗪25mg,西氯他宁50和150mg组平均尿钾排泄量[(57.6±1.9)、(49.6±1.9)、(50.5±1.9)比(45.0±1.9)mmol/d]和平均尿钠排泄量[(252.3±7.2)、(171.8±7.2)、(207.9±7.2)比(150.1±7.2)mmol/d]明显升高(均P<0.01)。与氢氯噻嗪25mg组比较,西氯他宁50和150mg组的尿钾排泄量较少。西氯他宁治疗高血压比氢氯噻嗪具有更好的耐受性和安全性。
This study compared the effects of single-dose thiazide diuretics, cicletanine and hydrochlorothiazide, on urinary sodium and potassium excretion in normotensive hypertensive and untreated grade 1 hypertensive patients and on the effects of G protein-coupled Effect of GRK4 Gene Polymorphism on Urinary Electrolyte Excretion Induced by Thiazide Diuretic in Rats. This study is a randomized, double-blind, placebo-controlled, phase 3, 4 different treatment (placebo, 25 mg hydrochlorothiazide, 50 and 150 mg hydrochlorothiazide, n = 6) Complete block crossover study. The urinary samples before and after the treatment were collected for 3 months and the urinary electrolyte excretion index of each group was compared. In addition, the study population had the same number of patients with GRK4 alleles <3 and ≥ 3 (n = 12). Compared with placebo, urinary potassium excretion was significantly higher in hydrochlorothiazide 25 mg and cilostazin 50 and 150 mg groups than in placebo [(57.6 ± 1.9), (49.6 ± 1.9), (50.5 ± 1.9) and (45.0 ± 1.9) mmol / d], respectively The mean urinary sodium excretion was significantly higher (252.3 ± 7.2, 171.8 ± 7.2, 207.9 ± 7.2, 150.1 ± 7.2 mmol / d, respectively, P <0.01). Compared with the hydrochlorothiazide 25mg group, urinary potassium excretion was lower in the 50 and 150 mg hydrochlorothiazide groups. Ciclopirox has better tolerability and safety than hydrochlorothiazide in the treatment of hypertension.