血尿酸与心功能不全研究进展

Research Progress of Uric Acid and Cardiac Insufficiency

近年来血尿酸与心功能不全的关系备受关注。心功能不全患者中常伴有血尿酸水平升高,且升高的血尿酸与心功能不全的发病率及不良预后密切相关。血尿酸对心功能不全的影响存在浓度差异,且受性别、肾功能及利尿剂应用等因素的影响。然而血尿酸对心功能不全影响的具体机制尚未完全阐明,越来越多的观点倾向于黄嘌呤氧化酶(XO)活性增加介导的氧化应激可能较尿酸本身的作用更为重要,所以有临床试验及动物实验分别致力于降尿酸治疗对心功能不全患者不良预后及临床症状影响的研究,其中最受关注的为XO抑制剂别嘌呤醇,然而结果却不尽一致。

In recent years,the relationship between serum uric acid and cardiac insufficiency has attracted great attention.Elevated levels of serum uric acid are often associated with cardiac dysfunction and are closely associated with the incidence of cardiac insufficiency and poor prognosis.The effects of serum uric acid on cardiac insufficiency are not only quantitatively different,but also affected by factors such as gender,renal function,and diuretic application.However,the specific mechanism of the effects of serum uric acid on cardiac insufficiency has not yet been fully elucidated,more and more opinions tend to believe that oxidative stress mediated by the increase of xanthine oxidase(XO)activity is more important than the role of uric acid itself,and there are clinical trials and animal experiments devoted to the study of the adverse prognosis and clinical symptoms of patients with cardiac insufficiency treated with uric acid lowering therapy,among which XO inhibitor allopurinol is the most studied,though the results are not consistent.