别嘌呤醇对合并高尿酸血症的空腹血糖受损患者内皮功能的影响  

Effect of allopurinol on the endothelial function of patients with impaired fasting glucose complicated with hyperuricemia

作　　者：张军霞[1] 陈诚[1] 张碧琳[1] 程阳杨 

机构地区：[1]广州军区武汉总医院内分泌科,430070

出　　处：《中华糖尿病杂志》2016年第10期618-622,共5页CHINESE JOURNAL OF DIABETES MELLITUS

基　　金：国家自然科学基金资助项目（81500654）

摘　　要：目的观察别嘌呤醇降尿酸治疗对合并高尿酸血症的空腹血糖受损（IFG）患者内皮功能的影响。方法选取2015年6月至9月于广州军区武汉总医院内分泌科门诊就诊的合并高尿酸血症的IFG患者90例为研究对象，随机数字表法分为别嘌呤醇组（45例）和对照组（45例）。两组在生活方式干预的基础上，分别予以别嘌呤醇或安慰剂治疗12周。检测治疗前后收缩压（sBP）、舒张压（DBP）、血尿酸、血肌酐（Cr）、C反应蛋白（CRP）、空腹血糖（FPG）、空腹胰岛素（FINS）、甘油三酯（TG）、总胆固醇（TC）以及血流介导的血管舒张功能（FMD）等指标。两组间计量资料比较采用独立样本t检验，计数资料比较采用卡方检验，血尿酸变化差值和FMD变化差值的相关性采用偏相关分析。结果（1）与干预前比较，别嘌呤醇组干预12周FMD明显升高f5．0±0．7比4．1＋0．6，t=-6．58，P〈0．05），别嘌呤醇组干预12周SBP、DBP、血尿酸、CRP、TC、TG明显降低（t=2．31～14．05，均P〈0．05）；（2）与对照组比较，别嘌呤醇组干预12周FMD明显升高（5．0±0．7比4.3±0．4，t=6．00，P〈0．05），血尿酸、SBP、DBP、CRP、TG明显降低（t=15．21- -2．35，均P〈0．05）；（3）与对照组比较，别嘌呤醇组12周后血尿酸、SBP、DBP、CRP、空腹胰岛素、稳态模型胰岛素抵抗指数及TG降低幅度更大（t=15．53-1．35，均P〈0．05），FMD增加幅度更大（t=22．79，P〈0．05）。结论别嘌呤醇降尿酸治疗可以改善合并高尿酸血症患者的IFG患者血管内皮功能。Objective To investigate the effect of allopurinol on the endothelial function of patients with impaired fasting glucose （IFG） complicated with hyperuricemia. Methods From June 2015 to September 2015, 90 outpatients with IFG combined with hyperuricemia were recruited. All the subjects were randomly assigned into allopurinol treatment group or control group by using random number table method. Besides the lifestyle intervention, the subjects were treated with allopurinol or placebo respectively for 12 weeks. Flow-mediated dilation （FMD） as well as systolic blood pressure （SBP）, diastolic blood pressure （DBP）, serum uric acid, serum creatinine, C-reactive protein （CRP）, fasting plasma glucose （FPG）, fasting insulin （FINS）, total cholesterol （TC） and triglyceride （TG） were measured before and after treatment. Independent-sample t test was used to compare measurement data between two groups. Categorical data were compared using the Chi-Square test. Correlation coefficients of changes between serum uric acid and FMD were calculated by partial correlation analysis. Results After treatment, in the allopurinol group, serum uric acid, SBP, DBP, CRP, TC, and TG were significantly decreased when compared with that before treatment （t=2.31-14.05, all P〈0.05 ）, and FMD was significantly increased after allopurinol treatment （4.1 ± 0.6 vs 5.0±0.7, t=-6.58, P〈0.05）. After 12 weeks, serum uric acid, SBP, DBP, CRP and TG decreased obviously （t=-15.21--2.35, all P〈0.05）for patients treated with allopurinol when compared with that in control group. Moreover, FMD increased significantly in subjects of allopurinol group （4.3±0.4 vs 5.0±0.7, t=6.00, P〈0.05）. Additionally, the changes of serum uric acid, SBP, DBP, CRP, FNS, HOMA-IR, and TG were more obvious in allopurinol group when compared with that in control group （t=-15.53--1.35, all P〈0.05）. There was a greater increase in FMD in allopurinol group（t=22.79,P〈O.05）. Conclusions The endothelial function coul

关 键 词：高尿酸血症 别嘌呤醇 空腹血糖受损 内皮功能 

分 类 号：R589.7[医药卫生—内分泌]