痛风发病年龄特征及降尿酸治疗对内皮功能的影响

Characteristics of onset age of gout and the effect of urate-lowering therapy on endothelial function

目的探讨痛风的发病年龄特征及降尿酸治疗对血管内皮功能的影响。方法回顾性分析我院2007年1月~2016年12月住院和门诊的231例痛风患者,选择其中72例患者随机分成两组(n=36),一组口服非布司他,一组口服别嘌呤醇,治疗前及治疗后12周行彩色多普勒超声检查内皮依赖性血管舒张功能。结果 (1)>60岁发病组痛风患者合并症发生率最高的是高血压病、肾脏病变、冠心病和脑血管病,其低密度脂蛋白、胆固醇、甘油三酯、尿酸水平最低。(2)降尿酸治疗12周后两组肱动脉内皮依赖性血管舒张功能增强(P<0.05),但两组间比较差异无统计学意义(P>0.05)。结论高龄发病的患者高血压病、肾病、冠心病和脑血管病的合并症发生率高。降尿酸治疗能改善患者血管内皮功能。

Objective To investigate the characteristics of onset age of gout and the effect of urate-lowering therapy on endothelial function. Methods 231 patients with gout who were hospitalized and diagnosed in outpatient clinic in our hospital from January 2007 to December 2016 were retrospectively analyzed. 72 patients were randomly divided into two groups（n=36）. One group was orally given febuxostat, and the other group was orally given allopurinol. Before and after treatment, color Doppler ultrasonography was used to examine endothelium-dependent vasodilatation 12 weeks after treatment. Results（1）The complications with the highest incidence rate in the patients with gout more than 60 years old in the onset group： hypertension, renal disease, coronary heart disease and cerebrovascular disease, and the low density lipoprotein, cholesterol, triglyceride, and uric acid levels were the lowest.（2）The endothelium-dependent vasodilatation function in brachial artery was enhanced 12 weeks after urate-lowering therapy（P〈0.05）, and there was no statistically significant difference between the two groups（P〈0.05）. Conclusion The incidence rate of complications of hypertension, nephropathy, coronary heart disease and cerebrovascular disease in the elderly patients is high. Urate-lowering therapy can improve the patient＇s vascular endothelial function.