中国临床药理学杂志

氯沙坦钾氢氯噻嗪治疗H型高血压合并骨质疏松症男性患者的临床研究

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杨祎祎 ^1a , 王潇 ^1a , 田雪莙 ² , 韩建龙 ^1b , 郭晓华 ^1a

中国临床药理学杂志 | 临床与基础桥接研究 2026,42(11): 1513-1519

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中国临床药理学杂志 |临床与基础桥接研究 2026 , 42 (11) : 1513 -1519

氯沙坦钾氢氯噻嗪治疗H型高血压合并骨质疏松症男性患者的临床研究

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杨祎祎^1a, 王潇^1a, 田雪莙², 韩建龙^1b, 郭晓华^1a

作者信息

^1a.济南市第四人民医院，检验科，山东济南 250021

^1b.济南市第四人民医院，骨科，山东济南 250021

^2.济南市槐荫人民医院检验科，山东济南 250021

通讯作者:

郭晓华，副主任技师 MP: 15165062944 E-mail: eddy5837@163.com

作者简介:

杨祎祎（1990-），女，主管技师，主要从事检验方面的工作和研究

Clinical trial of losartan potassium and hydrochlorothiazide in the treatment of male patients with H-type hypertension complicated with osteoporosis

Yi-yi YANG^1a, Xiao WANG^1a, Xue-jun TIAN², Jian-long HAN^1b, Xiao-hua GUO^1a

Affiliations

^1a.Department of Laboratory, Jinan Fourth People’s Hospital, Jinan 250021, Shandong Province, China

^1b.Department of Orthopaedics, Jinan Fourth People’s Hospital, Jinan 250021, Shandong Province, China

^2.Department of Laboratory Medicine, Huaiyin People’s Hospital, Jinan City, Jinan 250021, Shandong Province, China

出版时间: 2026-06-17 doi: 10.13699/j.cnki.1001-6821.2026.11.003

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摘要

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目的

探讨氯沙坦钾氢氯噻嗪片治疗H型高血压合并骨质疏松症男性患者的临床疗效和安全性。

方法

将H型高血压合并骨质疏松症男性患者根据随机数字表法分为对照组和试验组。2组均接受常规基础治疗，对照组在基础治疗上给予氨氯地平片，起始剂量每次5 mg，qd，治疗2~4 w后，血压未达标则调整为每次10 mg，qd；试验组在基础治疗上给予氯沙坦钾氢氯噻嗪片，起始剂量每次1片，qd，治疗2~4 w后，血压未达标则调整至每次2片，qd。2组均治疗12 w。比较2组患者的血压疗效、血压监测情况、血清同型半胱氨酸（Hcy）、胱抑素C（CysC）、叶酸、骨密度、骨代谢指标、炎症指标水平，并进行安全性评价。

结果

共纳入88例患者，试验组入组44例，对照组入组44例。试验组和对照组的总有效率分别为90.91%（40例/44例）和86.36%（38例/44例）（P>0.05）。治疗后，试验组和对照组的Hcy水平分别为（9.28±2.13）和（10.94±2.40）μmol·L^-1，CysC水平分别为（1.24±0.33）和（1.41±0.28）mg·L^-1，治疗后，试验组和对照组叶酸水平分别为（17.64±2.41）和（16.51±2.82）μg·L^-1，Ⅰ型胶原异构C端肽水平分别为（0.69±0.10）和（0.73±0.11）μg·L^-1，骨钙素水平分别为（20.81±3.67）和（19.11±2.64）μg·L^-1，骨特异性碱性磷酸酶水平分别为（17.85±2.68）和（16.62±3.03）μg·L^-1，碱性磷酸酶水平分别为（102.56±16.80）和（95.10±16.07）U·L^-1，高敏C反应蛋白水平分别为（10.45±1.31）和（11.64±1.82）mg·L^-1，基质金属蛋白酶-2水平分别为（296.23±33.59）和（319.23±42.70）pg·mL^-1，白细胞介素10水平分别为（19.21±2.79）和（17.42±2.96）ng·mL^-1，除叶酸外，上述指标2组间比较，在统计学上差异均有统计学意义（P<0.05，P<0.01）。治疗期间，试验组的主要药物不良反应包括头痛、头晕、恶心和腹泻，对照组则主要为下肢水肿、头痛、头晕和牙龈红肿；试验组和对照组的药物不良反应总发生率分别为11.36%（5例/44例）和13.64%（6例/44例）（P>0.05）。

结论

氯沙坦钾氢氯噻嗪片与氨氯地平片临床疗效及安全性相当，前者在短期治疗期间对骨代谢指标显示出积极影响，并在调控Hcy、CysC及炎症水平方面呈现一定积极变化趋势，可为该类患者的联合用药方案选择提供参考依据。

关键词

氯沙坦钾氢氯噻嗪片 / H型高血压 / 骨质疏松症 / 血压 / 骨代谢 / 骨密度

Abstract

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Objective

To explore the clinical efficacy and safety of losartan potassium and hydrochlorothiazide tablets in the treatment of male patients with H-type hypertension complicated with osteoporosis.

Methods

Male patients with H-type hypertension complicated with osteoporosis were prospectively and randomly divided into control group and treatment group according to the random number table method. Both groups received conventional basic treatment. The control group was given amlodipine tablets on the basis of basic treatment, with an initial dose of 5 mg once a day (qd). If the blood pressure was not controlled after 2 to 4 weeks of treatment, the dose was adjusted to 10 mg qd. The treatment group was given losartan potassium and hydrochlorothiazide tablets on the basis of basic treatment, with an initial dose of 1 tablet qd. If the blood pressure was not controlled after 2 to 4 weeks of treatment, the dose was adjusted to 2 tablets qd. Both groups were treated for 12 weeks. The blood pressure efficacy, blood pressure monitoring, serum homocysteine (Hcy), cystatin C (CysC), folic acid, bone mineral density, bone metabolism indicators, and inflammatory indicators of the two groups were compared, and safety was evaluated.

Results

A total of 88 patients were included, with 44 patients in the treatment group and 44 patients in the control group. The total effective rates of the treatment group and the control group were 90.91% (40 cases/44 cases) and 86.36% (38 cases/44 cases), respectively (P>0.05). After treatment, the Hcy levels of the treatment group and the control group were (9.28±2.13) and (10.94±2.40) μmol·L^-1, respectively; the CysC levels were (1.24±0.33) and (1.41±0.28) mg·L^-1, respectively; the folic acid levels in the treatment group and control group were (17.64±2.41) and (16.51±2.82) μg·L^-1, the type I collagen C-terminal telopeptide levels were (0.69±0.10) and (0.73±0.11) μg·L^-1, respectively; the osteocalcin levels were (20.81±3.67) and (19.11±2.64) μg·L^-1, respectively; the bone-specific alkaline phosphatase levels were (17.85±2.68) and (16.62±3.03) μg·L^-1, respectively; the alkaline phosphatase levels were (102.56±16.80) and (95.10±16.07) U·L^-1, respectively; the high-sensitivity C-reactive protein levels were (10.45±1.31) and (11.64±1.82) mg·L^-1, respectively; the matrix metalloproteinase-2 levels were (296.23±33.59) and (319.23±42.70) pg·mL^-1, respectively; and the interleukin-10 levels were (19.21±2.79) and (17.42±2.96) ng·mL^-1, respectively. Except folic acid, the differences of above indexes were all statistically significant (P<0.05, P<0.01). In the treatment group, adverse drug reactions included headache, dizziness, nausea and diarrhea; in the control group, adverse drug reactions included lower limb edema, headache, dizziness and gingival swelling. The total incidence of adverse drug reactions in the treatment group and the control group was 11.36% (5 cases/44 cases) and 13.64% (6 cases/44 cases), respectively (P>0.05).

Conclusion

Losartan potassium and hydrochlorothiazide tablets and amlodipine tablets have comparable efficacy and safety. The former showed positive effects on bone metabolism indicators during short-term treatment, and presented a certain positive trend in regulating Hcy, CysC, and inflammatory levels, which may provide a reference for the selection of combined medication regimens for such patients.

Key words

losartan potassium and hydrochlorothiazide tablets / H-type hypertension / osteoporosis / blood pressure / bone metabolism / bone mineral density

引用本文

杨祎祎, 王潇, 田雪莙, 韩建龙, 郭晓华. 氯沙坦钾氢氯噻嗪治疗H型高血压合并骨质疏松症男性患者的临床研究. 中国临床药理学杂志, 2026 , 42 (11) : 1513 -1519 . DOI: 10.13699/j.cnki.1001-6821.2026.11.003

Yi-yi YANG, Xiao WANG, Xue-jun TIAN, Jian-long HAN, Xiao-hua GUO. Clinical trial of losartan potassium and hydrochlorothiazide in the treatment of male patients with H-type hypertension complicated with osteoporosis[J]. Chinese Journal of Clinical Pharmacology, 2026 , 42 (11) : 1513 -1519 . DOI: 10.13699/j.cnki.1001-6821.2026.11.003

基金

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济南市卫生健康委员会科技发展计划基金资助项目(2024208003)

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2026年第42卷第11期

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doi: 10.13699/j.cnki.1001-6821.2026.11.003

接收时间：2026-01-12
首发时间：2026-08-06
出版时间：2026-06-17

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收稿日期：2026-01-12

基金

济南市卫生健康委员会科技发展计划基金资助项目(2024208003)

作者信息

^1a.济南市第四人民医院，检验科，山东济南 250021

^1b.济南市第四人民医院，骨科，山东济南 250021

^2.济南市槐荫人民医院检验科，山东济南 250021

通讯作者:

郭晓华，副主任技师 MP: 15165062944 E-mail: eddy5837@163.com

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https://castjournals.cast.org.cn/joweb/zglcylxzz/CN/10.13699/j.cnki.1001-6821.2026.11.003

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2种不同金属材料的力学参数

科 Family	属数 Number of genus	种数 Number of species	占总种数比例 Percentage of total species (%)	属 Genus	种数 Number of species	占总种数比例 Percentage of total species (%)
鹅膏菌科Amanitaceae	2	11	5.26	鹅膏菌属 Amanita	10	4.78
小菇科 Mycenaceae	2	12	5.74	丝盖伞属 Inocybe	5	2.39
多孔菌科 Polyporaceae	8	14	6.70	蜡蘑属 Laccaria	5	2.39
红菇科 Russulaceae	3	23	11.00	小皮伞属 Marasmius	6	2.87
				小菇属 Mycena	11	5.26
				光柄菇属 Pluteus	5	2.39
				红菇属 Russula	17	8.13
				栓菌属 Trametes	5	2.39

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