别嘌呤醇对动脉粥样硬化伴高尿酸血症患者的影响研究

Impact of Allopurinol on Atherosclerosis Complicated with Hyperuricemia

目的探讨别嘌呤醇对动脉粥样硬化伴高尿酸血症患者的影响。方法选择2013年5月—2014年5月西安市五环医院收治的动脉粥样硬化伴高尿酸血症患者85例,按照随机数字表法分为对照组42例和试验组43例。对照组患者予以常规药物治疗,试验组患者在常规药物治疗基础上予以别嘌呤醇;两组患者均连续治疗3个月。比较两组患者治疗前后血压(收缩压和舒张压)、空腹血糖(FBP)、血脂指标、肝肾功能指标、超敏C反应蛋白(hs-CRP)、踝臂指数(ABI)、臂踝脉搏波传导速度(ba PWV),记录治疗期间不良反应发生情况。结果两组患者治疗前收缩压、舒张压比较,差异无统计学意义(P>0.05);试验组患者治疗后收缩压、舒张压均低于对照组(P<0.05)。两组患者治疗前FBG、总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL)、低密度脂蛋白(LDL)比较,差异均无统计学意义(P>0.05);试验组患者治疗后FBG、TC、TG、LDL低于对照组,HDL高于对照组(P<0.05)。两组患者治疗前丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿素氮(BUN)、肌酐(Cr)、肾小球滤过率(GFR)、尿酸(UA)、hs-CRP比较,差异均无统计学意义(P>0.05);试验组患者治疗后ALT、AST、BUN、Cr、UA、hs-CRP低于对照组,GFR高于对照组(P<0.05)。两组患者治疗前左侧和右侧ABI、baPWV及治疗后左侧和右侧ABI比较,差异均无统计学意义(P>0.05);试验组患者治疗后baPWV低于对照组(P<0.05)。两组患者治疗期间均未出现明显不良反应。结论别嘌呤醇可有效降低动脉粥样硬化伴高尿酸血症患者血压及血糖,改善患者血脂代谢、肝肾功能、动脉粥样硬化程度及动脉弹性。

Objective To investigate the impact of allopurinol on atheroscterosis complicated with hyperuricemia. Methods A total of 85 atherosclerosis patients complicated with hyperuficemia were selected in the Wuhuan Hospital of Xi＇an from May 2013 to May 2014, and they were divided into control group （n =42） and test group （n =43） according to random number table. Patients of control group received.conventional medical treatment, while patients of test group received allopurinol based on conventional medical treatment; both groups treated for 3 months. Systolic blood pressure, diastolic blood pressure, FBP, blood lipids index, indicators of liver and kidney function, hs-CRP, ABI and baPWV were compared between the two groups, incidence of adverse reactions during treatment was recorded. Results No statistically significant differences of systolic blood pressure or diastolic blood pressure was found between the two groups before treatment （ P 〉 0. 05 ） ; while systolic blood pressure and diastolic brood pressure of test group were statistically significantly lower than those of control group after treatment （ P 〈 0.05 ）. No statistically significant differences of FBG, TC, TG, HDL or LDL was found between the two groups before treatment （P 〉 0. 05 ） ; after treatment, FBG, TC, TG and LDL of test group were statistically significantly lower than those of control group, while HDL of test group was statistically significantly higher than that of control group （ P 〈 0. 05 ）. No statistically significant differences of ALT, AST, BUN, Cr, GFR, UA or hs-CRP was found between the two groups before treatment （P 〉0.05）; after treatment, ALT, AST, BUN, Cr, UA and hs-CRP of test group were statistically significantly lower than those of control group, while GFR of test group was statistically significantly higher than that of control group （ P 〈 0.05）. No statistically significant differences of left - side ABI, fight - side ABI or baPWV was found between the two groupsbefore treatment, nor was left - side ABI or right - side ABI between the two groups after treatment （ P 〉 0.05 ）, while baPWV of test group was statistically significantly lower than that of control group after treatment （ P 〈 0. 05 ）. No one of the two groups occurred any obvious adverse reactions during treatment. Conclusion Allopurinol can effectively reduce the blood pressure and blood glucose of atherosclerosis patients complicated with hyperuricemia, improve the blood lipid metabolism, liver and kidney function, reliere the severity of atherosclerosis and improvethe arterial elasticity.