高尿酸血症对初诊糖尿病患者高敏C反应蛋白和心率变异性的影响及早期干预效果  

Effect of hyperuricemia and the early intervention of Benzbromarone on high-sensitive C-reactive protein and heart rate variability in patients with newly diagnosed type 2 diabetes mellitus

作　　者：刘静芹[1] 张桂玲[1] 王宁[1] 栾芳[1] 魏巍[1] 尹贺欣[1] LIU Jing-qin ZHANG Gui-ling WANG Ning LUAN Fang WEI Wei YIN He-xin(Department of Endocrinology, The First Hospital of Baoding, Baoding, Hebei Province 071000, China)

机构地区：[1]保定市第一医院内分泌科,河北省保定071000

出　　处：《中国慢性病预防与控制》2017年第5期333-336,共4页Chinese Journal of Prevention and Control of Chronic Diseases

摘　　要：目的探讨高尿酸血症(HUA)对初诊2型糖尿病(T2DM)患者高敏C反应蛋白(hs-CRP)和心率变异性(HRV)的影响及苯溴马隆早期干预效果,为糖尿病心脏自主神经病变(CAN)的防治提供依据。方法选取2010年1月至2016年6月在保定市第一医院内分泌科新诊断的T2DM患者60例为T2DM组,将新诊断的126例T2DM合并HUA患者随机分为苯溴马隆组和常规治疗组,每组63例。T2DM组和常规治疗组给予低盐、低脂、低嘌呤饮食及二甲双胍治疗;苯溴马隆组在常规治疗组的基础上加用苯溴马隆50 mg/d,口服,共治疗12周。治疗前及治疗后12周,对患者进行空腹血糖(FPG)、糖化血红蛋白(Hb A1C)、血脂、血尿酸(SUA)、高敏C反应蛋白(hs-CRP)及肝肾功能的检测;行24 h动态心电图监测,分析HRV时域和频域指标。应用SPSS 17.0软件对数据进行统计分析。结果治疗前,与T2DM组比较,苯溴马隆组和常规治疗组SUA、hs-CRP水平均明显升高,总体标准差(SDNN)、差值均方的平方根(r MSSD)、爱丁堡指数(PNN50)、低频(LF)、高频(HF)及LF/HF比值降低,差异均有统计学意义(P<0.05,P<0.01)。治疗后,苯溴马隆组与本组治疗前和常规治疗组治疗后比较,SUA、hs-CRP水平均明显降低,SDNN、r MSSD、PNN50、LF、HF均明显升高,差异均有统计学意义(P<0.05);LF/HF比值高于本组治疗前,差异有统计学意义(P<0.05,P<0.01),但与常规治疗组治疗后比较,差异无统计学意义(P>0.05)。结论 HUA可影响初诊T2DM患者的hs-CRP和HRV,通过降低SUA水平,可以改善患者hs-CRP水平和HRV,其疗效可能与机体炎症反应的改善有关。Objective To study the effects of hyperuricemia （HUA） on high-sensitive C-reactive protein （hs-CRP） and heart rate variability （HRV） and the early intervention effects of Benzbromarone in type 2 diabetes mellitus （T2DM） patients and to provide a valid basis for the prevention and treatment of diabetic cardiac autonomic neuropathy （CAN）. Methods From January of 2010 to June of 2016, 60 newly diagnosed T2DM patients and 126 newly diagnosed T2DM patients with HUA were selected as the subjects, 126 newly diagnosed T2DM patients with HUA were randomly divided into Benzbromarone group （63 cases） and convention therapy group （63 cases）. T2DM group and conventi^gn therapy group were treated with metformin, low salt, low fat and low purine diet; Benzbromarone group was treated with 50 mg/d Benzbromarone plus above therapy for 12 weeks. Before treatment and 12 weeks after treatment, fasting plasma glucose （FPG）, glycosylated hemoglgbin （HbAlc）, blood lipids, serum uric acid （SUA）, hs - CRP,hver and kidney functions were tested and24 hour dynamic electrocardiogram record was performed for all subjects. HRV time domain and frequency domain indicators were analyzed. SPSS 17.0 software was used for statistic analysis. Results Before treatment, as compared with T2DM group, SUA and hs-CRP levels in Benzbromarone group and convention therapy group significantly increased, the standard deviation of NN intervals （ SDNN ）, the difference of mean square root （rMSSD）, Edinburgh index （PNNS0）, low frequency （LF）, high frequency （HF） and LF/HF ratio significantly decreased （P〈0.05, P〈0.01 ）. In 12 weeks after treatment, as compared with convention therapy group and Benzbromarone group before treatment, SUA and hs-CRP levels in Benzbromarone group significantly decreased, the levels of SDNN, rMSSD, PNNS0, LF and HF significantly increased （P〈0.05）; LF/HF ratio in Benzbromarone group was significantly higher than that in Benzbromarone group before （P〈0.01）. Co

关 键 词：糖尿病 2型 高尿酸血症 高敏C反应蛋白 心率变异性 苯溴马隆 

分 类 号：R587.1[医药卫生—内分泌]