别嘌醇对合并高尿酸血症的慢性心力衰竭患者心功能及运动耐量的影响

Effects of allopurinol on cardiac function and exercise capacity in hyperuricemic patients with congestive heart failure

目的观察别嘌醇对合并高尿酸血症的慢性心力衰竭(心衰)患者心功能及6min步行试验距离(6MWT)的影响。方法80例心衰伴高尿酸血症患者,随机分为对照组和别嘌醇组,各40例,对照组给予标准的抗心衰治疗,别嘌醇组在对照组的治疗基础上加用别嘌醇每天0.3g。动态观察心衰患者治疗前和治疗后1个月血清尿酸水平和心功能(纽约NYHA分级)变化,测定心衰患者治疗前和治疗后3个月6MWT并同时使用超声心动图测定左心室射血分数和左心室舒张末期内径。结果别嘌醇组血清尿酸水平、NYHA分级、左心室射血分数、左心室舒张末期内径、6MWT改善情况均优于对照组,差异有统计学意义(P<0.05或P<0.01)。结论别嘌醇降低尿酸水平的同时,能明显改善心衰患者的心室重构及心功能,提高心衰患者的运动耐量。6MWT可作为评价别嘌醇治疗慢性心衰患者疗效评估指标。

Objective To investigate the effects of allopurinol on changes in cardiac function and six-minute walk test （6MWT） distances in hyperurieemic patients with congestive heart failure（CHF）. Metheds 80 hyperurieemic with CHF were randomly divided into aUopurinol group and control group,4Ocases of each group. The allopurinol group was given alloprinol 0. 3g once a day based on the cunvetianal therapy. The control group was given conventional therapy. Observe the changes of plasina uric acid and NYHA functional class were evaluated before and after treatment 1 month. The eehocardiographic indices and 6MWT distances were measured before and after treatment 3 months. Results The improvement of the allopurinol group＇ s restdts of uric acid,NYHA functional class,LVEF,LVED and 6MWT were better than the control group,the difference was statisticaly significant（ P 〈0.05 or P 〈0. 01 ）. Conclusion Allopurinol can not only improve left ventricnlar remodeling and cardiac function but also increase exercise capacity in hyperuricemic patients with CHF. 6MWT may serve as a therapeutic indicator for allopurinol treatmemt in CHF patients.