别嘌呤醇治疗慢性心力衰竭合并高尿酸血症的疗效观察

To Observe the Effects Allopurinol on Cardiac Function and Serum Uric Acid in Hyperuricemic Patients with Chronic Heart Failure

目的:探讨别嘌呤醇治疗慢性心力衰竭合并高尿酸血症患者的疗效。方法:选择2009-12～2012-02在我院住院的慢性心力衰竭患者血尿酸增高的患者68例,随机分为治疗组36例和对照组32例,治疗组和对照组均通过查房随访和健康讲座提倡合理的生活方式和心衰规范化药物治疗。治疗组给与别嘌呤醇(0.25 g),1次/d。随访3个月后观察两组患者血清中血尿酸水平的变化和随访期心功能(NYHA)分级及超声心动图中心功能指数的变化情况。结果:治疗组在3个月治疗后血清血尿酸水平明显下降(P<0.05),对照组血清中血尿酸水平无明显变化。随访期间对照组心功能NYHA分级变化总有效率为85.3%,治疗组为60.8%,两组之间有统计学差异(P<0.05);治疗组治疗前后超声心动图中左室射血分数(LVEF)明显增高及左室舒张末期内径(LVEDD)明显降低,两组之间有统计学差异(P<0.05)。结论:别嘌呤醇治疗伴有血尿酸增高的慢性心力衰竭患者可以显著降低患者血清中血尿酸水平,同时有效改善心功能。

Objective：To observe the effects allopurinol on cardiac function and serum uric acid in hyperuricemic patients with chronic heart failure. Methods ：98 hyperuricemic patients with chronic heart failure were randomly divided in two groups. All patients in the two groups were given the routine treatment with antihypertensive drug and healthy education lecture. 36patients in the treatment group were given oral allopurinol （250 mg） once a day for 3 monthsin addition to the standard anti - heart failure treatment. Compare the change between the serum uric acid level, the level of cardiac function with NYHA an, Left Ventrieular Ejiect Fraction （LVEF） and Left Ventricular End -diastolic Diameter （LVEDD）. Results：In the allopurinol treatment group the serum uric acid decreased （P 〈 0. 05） ; LVEDD shrinked （P 〈 0.05 ） and LVEF increased （ P 〈 0. 05 ） significantly. Conclusions： The treatment of fixed combination of allopurinol patients can reduced the level of serum uric acid and improve cardiac funtion in patients with chronic heart failure markedly.