别嘌呤醇治疗不稳定型心绞痛并高尿酸血症的疗效观察  

Effect of allopurinol on unstable angina pectoris complicated with hyperuicemia

作　　者：尹刚 韩娜 李越凡 

机构地区：[1]青岛市中心医院心内科,山东青岛266042

出　　处：《中华实用诊断与治疗杂志》2015年第1期93-94,97,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的观察不稳定型心绞痛并高尿酸血症患者应用别嘌呤醇治疗的疗效和安全性。方法 79例不稳定型心绞痛并高尿酸血症患者随机分为观察组41例和对照组38例,对照组给予常规治疗,观察组在常规治疗基础上口服别嘌呤醇,初始剂量为50mg/次,2次/d,每周递增50mg/次,至200mg/次,2次/d,维持;2组疗程均为3个月。比较2组治疗后心肌梗死溶栓疗法(the Thrombolysis in Myocardial Infarction,TIMI)危险评分、全球急性冠状动脉事件注册(Global Registry of Acute Coronary Events,GRACE)评分、心绞痛分级及血尿酸水平,记录治疗后心电图运动负荷试验ST最大压低水平、运动开始至终止时间、运动最快心率,观察2组不良反应发生情况。结果观察组治疗后TIMI评分(2.2±0.9)、GRACE评分(76.3±22.8)和血尿酸水平((354.6±31.3)μmol/L)低于治疗前(3.2±1.2、104.6±30.1、(477.6±26.4)μmol/L)(P<0.05)和对照组治疗后(2.7±1.1、88.5±23.9、(459.9±33.2)μmol/L)(P<0.05);观察组治疗后心绞痛分级改善较治疗前和对照组明显(P<0.05);观察组治疗3个月后ST最大压低水平((-0.81±0.26)mV)、运动开始至终止时间((313.2±54.3)s)、运动最快心率((129.2±18.4)次/min)与对照组((-0.94±0.30)mV、(275.5±48.9)s、(116.2±15.2)次/min)比较差异均有统计学意义(P<0.05);2组均未发生明显药物不良反应,观察组上腹部隐痛发生率(14.6%)与对照组(13.2%)比较差异无统计学意义(P<0.05)。结论不稳定型心绞痛并高尿酸血症患者在常规治疗基础上应用别嘌呤醇可减轻患者心肌缺血、增加患者活动耐力,改善心绞痛程度,且不良反应轻。Objective To observe the effect and safety of allopurinol in the treatment of unstable angina pectoris complicated with hyperuicemia. Methods Seventy-nine patients with unstable angina pectoris complicated with hyperuicemia were randomly divided into observation group（n=41）and control group（n=38）.Control group received conventional therapy.Observation group was orally administered allopurinol at the initial dose of 50 mg each time,twice a day,followed by an increased dose of 50 mg each time every week till the dose of 200 mg each time twice a day,besides the conventional therapy in control group.Both two groups were treated for 3months.The Thrombolysis in Myocardial Infarction（TIMI）score,Global Registry of Acute Coronary Events（GRACE）score,angina pectoris grade and serum uric acid level were compared between two groups.The maximal ST segment depression,the total exercise time and the maximal heart rate in ECG stress test were recorded.The adverse reactions were observed.Results The TIMI score（2.2±0.9）,GRACE score（76.3±22.8）and serum uric acid level（（354.6±31.3）μmol/L）in observation group were lower than those in control group（3.2±1.2,104.6±30.1,（477.6±26.4）μmol/L）after treatment（P〈0.05）.Angina pectoris grade in observation group was improved more greatly than that in control group after treatment（P〈0.05）.The maximal ST segment depression（（-0.81±0.26）mV）,the total exercise time（（313.2±54.3）s）and the maximal heart rate（（129.2±18.4）beat/min）in observation group were significantly different from those in control group（（-0.94±0.30）mV,（275.5±48.9）s,（116.2±15.2）beat/min）（P〈0.05）.No obvious adverse reaction was observed in both groups.There was no significant difference in the incidence of upper abdominal vague pain between observation group（14.6%）and control group（13.2%）（P〉0.05）.Conclusion Allopurinol plus conventional therapy can alleviate myocardial ischemia,increase the activity tolerance and

关 键 词：不稳定型心绞痛 高尿酸血症 别嘌呤醇 心电图负荷试验 

分 类 号：R541.4[医药卫生—心血管疾病]