降尿酸治疗对痛风合并冠心病患者外周血内皮微粒含量及主要不良心血管事件的影响

Effect of uric acid lowering therapy on content of endothelial microparticles in peripheral blood and major adverse cardiovascular events in patients with gout complicated with coronary heart disease

目的探讨降尿酸治疗对痛风合并冠心病患者外周血内皮微粒(EMPs)含量及主要不良心血管事件(MACE)的影响。方法选取137例痛风合并冠心病患者为研究对象,均存在高尿酸血症。使用非布司他治疗3个月后,将患者根据尿酸达标情况分为达标组70例和非达标组67例。比较2组患者治疗前后EMPs含量及降尿酸治疗1年内MACE发生率。结果治疗后,2组EMPs含量均低于治疗前,差异有统计学意义(P<0.05);达标组治疗后EMPs含量为(1.64±0.48)%,低于非达标组的(1.97±0.47)%,差异有统计学意义(P<0.05)。EMPs降低水平与尿酸降低水平呈正相关(r=0.374,P<0.05)。达标组降尿酸治疗1年内MACE发生率为15.71%,低于非达标组的31.34%,差异有统计学意义(P<0.05)。结论达标性降尿酸治疗能够显著改善痛风合并冠心病患者的血管内皮功能,降低MACE发生率。

Objective To investigate the effect of uric acid lowering therapy on content of endothelial microparticles(EMPs)in peripheral blood and major adverse cardiovascular events(MACE)in patients with gout complicated with coronary heart disease.Methods A total of 137 patients with gout complicated with coronary heart disease were selected as research objects,and all the patients had hyperuricemia.After 3 months of treatment with febuxostat,the patients were divided into qualified group(n=70)and non-qualified group(n=67)according to qualified condition of uric acid.The content of EMPs before and after treatment and the incidence of MACE within one year of uric acid lowering therapy were compared between the two groups.Results After treatment,the content of EMPs in both groups decreased significantly(P<0.05);the content of EMPs after treatment in the qualified group was(1.64±0.48)%,which was significantly lower than(1.97±0.47)%in the non-qualified group(P<0.05).The decreased level of EMPs was positively correlated with the decreased level of uric acid(r=0.374,P<0.05).The incidence of MACE in the qualified group was 15.71%within one year of uric acid lowering therapy,which was significantly lower than 31.34%in the non-qualified group(P<0.05).Conclusion Qualified uric acid lowering therapy can significantly improve the vascular endothelial function of gout patients complicated with coronary heart disease,and reduce the incidence of MACE.