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目的观察别嘌呤醇对高尿酸血症患者动脉弹性的短期影响,为动脉粥样硬化早期干预提供指导。方法选择高尿酸血症患者59例,随机分为别嘌呤醇组和对照组,治疗3个月后观察血压、血糖、血脂、肝肾功、高敏C反应(hsCRP)、尿酸(UA)、臂踝脉搏波速度(baPWV)及踝臂指数(ABI)的变化及药物不良反应。结果所有患者均完成随访,无严重不良反应发生。治疗3个月后,别嘌呤醇组收缩压、舒张压(P<0.01),hsCRP(P<0.05)低于对照组。别嘌呤醇组治疗3个月后收缩压、舒张压、hsCRP,UA、baPWV较治疗前显著下降(P<0.01)。对照组hsCRP及UA较治疗前显著下降(P<0.01)。别嘌呤醇的应用及hsCRP的下降为baPWV下降的独立影响因子。结论别嘌呤醇可安全有效治疗高尿酸血症,同时可以降低血压及baPWV,改善血管弹性,逆转早期动脉硬化,baPWV的下降与炎症状态改善有关,不依赖于尿酸的变化。
Objective To observe the short-term effects of allopurinol on arterial elasticity in patients with hyperuricemia and provide guidance for the early intervention of atherosclerosis. Methods 59 patients with hyperuricemia were randomly divided into allopurinol group and control group. After 3 months of treatment, blood pressure, blood glucose, blood lipid, liver and kidney function, hsCRP, UA, Ankle pulse wave velocity (baPWV) and ankle brachial index (ABI) changes and adverse drug reactions. Results All patients were followed up, no serious adverse reactions occurred. After 3 months of treatment, the systolic pressure and diastolic pressure of allopurinol group (P <0.01), hsCRP (P <0.05) were lower than those of the control group. The systolic blood pressure, diastolic blood pressure, hsCRP, UA and baPWV in allopurinol group were significantly decreased 3 months after treatment (P <0.01). The levels of hsCRP and UA in the control group decreased significantly (P <0.01). The use of allopurinol and the reduction of hsCRP were independent predictors of decreased baPWV. Conclusion Allopurinol is safe and effective in the treatment of hyperuricemia. At the same time, allopurinol can reduce blood pressure and baPWV, improve blood vessel elasticity and reverse early atherosclerosis. The decrease of baPWV is associated with the improvement of inflammatory status, which is independent of uric acid.