别嘌呤醇对慢性肾衰竭患者肾脏保护作用及机制

Effects of allopurinol on kidney in patients with chronic renal failure and protective mechanism

目的观察别嘌呤醇对慢性肾衰竭（CRF）患者肾功能的保护作用。方法将入选的86例CRF（除外尿酸性肾病）患者分成对照组和治疗组，对照组给予CRF常规非透析疗法治疗；治疗组则在对照组基础上加用别嘌呤醇治疗；观察4周。测定2组治疗前后患者的尿素氮（BUN）、血肌酐（SCr）、血尿酸、一氧化氮（NO），内皮素1（ET-1），血栓素B2（TXB2）、6-酮-前列腺素F1α（6-keto-PGF-1α）及超敏C反应蛋白（hs-CRP）。结果治疗组治疗后，BUN、SCr及血尿酸较同组治疗前显著降低（P〈0．05），与对照组比较有统计学差异（P〈0．05）；ET-1和NO分别较同组治疗前降低和升高（P〈0．05），TXB2和6-keto-PGF-1α分别较治疗前降低和升高（P〈0．05），hs-CRP较同组治疗前下降（P〈0．05），与对照组比较均有统计学差异（P〈0．05）。结论别嘌呤醇对CRF患者肾功能具有保护作用，其可能是通过抗微炎症状况和改善血管内皮功能的作用。

Objective To investigate the effects of allopurinol on kidney in patients with chronic renal failure,and discuss the possible mechanism. Methods Eighty-six cases of chronic renal failure having no gout-induced nephropathy were divided into two groups randomly： control group receiving conventional un-hemodialysis therapy; treatment group receiving conventional treatment combined with allopurinol treatment. The treatment duration was 4 weeks. The BUN, SCr, HA, NO, ET, TXB2 and 6-keto-PGF-la were determined before and after treatmentl. Results After treatment, the levels of BUN, SCr and uric acid were significantly lower than those before the treatment and control group （all P^0. 05）. The levels of EG, TXB2 and hs-CRF in treatment group were reduced, and those of NO and 6-keto-PGF-1 a were increased as compared with those before the treatment and control group （all P% 0. 05）. Conclusions Allopurinol can protect the renal function of patients with chronic renal failure by antagonizing vasculitis and improving function of vascular endothelial cells.