心衰患者尿酸对血管内皮功能的影响及别嘌呤醇的干预  

Effects of allopurinol on vascular endothelial function in patients with chronic heart failure

作　　者：杨海玉[1] 曾玉杰[2] 廖琼[1] 张红环[1] 杨春梅[1] 

机构地区：[1]广东省江门市中心医院,529070 [2]北京中日友好医院

出　　处：《医师进修杂志》2005年第10期32-34,共3页Journal of Postgraduates of Medicine

摘　　要：目的探讨心力衰竭(心衰)患者尿酸(UA)升高对血管内皮功能的影响及别嘌呤醇干预对尿酸升高的慢性心衰内皮依赖性血管舒张功能的影响。方法将30例心衰患者随机分为别嘌呤醇组和对照组,对照组15例,用常规药物治疗2周;别嘌呤醇组15例,在常规药物治疗基础上加用别嘌呤醇。采用高分辨超声技术检测血流介导和硝酸甘油介导的肱动脉舒张功能,并测定治疗前后血浆UA和内皮素(ET-1)。结果(1)用药前,二者比较UA水平及ET-1水平,差异无统计学意义(P>0.05);用药后,别嘌呤醇组UA水平及ET-1水平和对照组比较均降低,差异有统计学意义(P<0.05)。各组用药后UA水平及ET-1水平均明显降低(P<0.01)。(2)别嘌呤醇组和对照组肱动脉内径基础值无明显差异(P>0.05),反应性充血引起肱动脉内径变化别嘌呤醇组明显增加(P<0.01)。含服硝酸甘油后两组肱动脉内径均明显扩张,但两组肱动脉内径变化无明显差异(P>0.05)。结论心衰患者经药物干预后,UA水平降低,ET-1水平随之下降,尤以别嘌呤醇组降低明显。别嘌呤醇治疗后UA水平明显降低,内皮依赖性血管舒张功能明显改善,别嘌呤醇是慢性心衰的一种便宜而有效的辅助药物。Objective To study the effects of allopurinol on vascular endothelial function with chronic heart failure. Methods Thirty cases with chronic heart failure were divided into two groups, allopurinol group and control group. With high - resolution ultrasound, flow - and nitroglycerin induced dilation of the brachial artery was measured in two groups. Both serum uric acid （UA） and plasma endotirelin- 1 （ET- 1） levels were determined before and after therapy at the same time. Results （ 1 ） In allopurinol group, flow- induced vasodilatation was much reduced compared with that in the control subjects （P 〈 0.01）. However, vasodilatation in response to nitroglycerin was similar in both groups （P 〉 0.05）. （2） Plasma UA level and ET- 1 level in the cases ware lower before therapy titan after therapy （ P 〈 0.05）, allopurinol group lower significantly （ P 〈 0.01 ）. Conclusions Plasma UA level and ET- 1 level were related to heart failure; In patients of chronic heart failure, allopurinol improves endothelium- dependent vasodilatation function and maybe as a helpful therapy to heart failure.

关 键 词：心力衰竭 别嘌呤醇 尿酸 内皮 血管舒张 血管内皮功能 心衰患者 尿酸升高 内皮依赖性血管舒张功能 ET-1水平 

分 类 号：R541.4[医药卫生—心血管疾病] R758.25[医药卫生—内科学]