别嘌醇改善非高尿酸血症慢性心力衰竭患者心功能  

Allopurinol ameliorates cardiac function in non-hyperuricemic patients with chronic heart failure

作　　者：肖骏[1] 李均[1] 张颖[1] 岳瑞华[1] 沈钧乐[1] 

机构地区：[1]重庆市急救医疗中心心内科,重庆400014

出　　处：《基础医学与临床》2012年第11期1322-1325,共4页Basic and Clinical Medicine

摘　　要：目的观察别嘌醇对非高尿酸血症慢性心力衰竭患者心功能的影响及应用安全性。方法连续入选2008年7月～2009年6月重庆市急救医疗中心非高尿酸血症慢性心衰患者125例,随机分为别嘌醇(300 mg/d)组(n=62)与对照组(n=63),治疗6个月。常规检测心功能、肱动脉血管内皮功能、炎性因子与生化指标。结果加用别嘌醇3个月时加压反应性充血前后血管内径变化百分率增加;6个月时心功能分级改善,血浆脑利钠肽和肿瘤坏死因子-α水平下降,左心室内径缩小,射血分数增加(均P<0.01)。两组血尿酸均降低但无差异,无肝肾功能异常,肌酸激酶无明显增高。结论非高尿酸血症慢性心衰患者加用别嘌醇治疗6个月安全、有效,可显著改善左心功能及降低炎性因子水平,并可能改善血管内皮功能。Objective To investigate the efficacy and safety of adding allopurinol on top of standard therapy in non-hyperuricemic patients with chronic heart failure.Methods A total of 125 patients hospitalized from July 2008 to June 2009 were randomly divided into allopurinol group（allopurinol 300 mg/d on top of standard therapy,n=62） and control group（standard therapy,n=63） and followed 6 months.The changes in cardiac function,flow-mediated vasodilatation（FMD） of brachial artery,plasma inflammatory factors level,1iver and kidney function were observed.Results In allopurinol treated patients,FMD of brachial artery significantly increased after 3 months.NYHA stage significantly improved,plasma BNP,TNF-α levels and LVEDD decreased and LVEF significantly increased 6 months after treatment compared to control group（all P0.01）.There were no significant differences in plasma uric acid levels between both groups.No event on liver and kidney dysfunction was noticed.Conclusions Allopurinol was effective and safe in non-hyperuricemic patients with chronic heart failure,it can significantly ameliorate left ventricular functions,reduce the levels of inflammatory factors,and may improve vascular endothelial function as well.

关 键 词：别嘌醇 心力衰竭 尿酸 

分 类 号：R541.6[医药卫生—心血管疾病]