别嘌呤醇对伴高尿酸血症糖尿病肾病患者血尿酸及尿蛋白排泄率的影响  

Effects of allopurinol on serum uric acid and urinary protein excretion of diabetic nephropathy patients with hyperuricemia

作　　者：何立芳[1] 阎双缓[2] 李宏山[3] 王冬梅[1] 任平香[1] HE Li-fang;YAN Shuang-huan;LI Hong-shan;WANG Dong-mei;REN Ping-xiang(Department of Endocrinology and Nephrology,Tangshan Fengrun People＇s Hospital,HebeiProvince,Tangshan 064000,China;Department of Infectious Diseases,the Fifth Hospital ofShijiazhuang,Hebei Province,Shijiazhuang 050021,China;Department of IntensiveCare Unit,Tangshan People′s Hospital,Hebei Province Tangshan 063000,China)

机构地区：[1]河北省唐山市丰润区人民医院内分泌肾内科,河北唐山064000 [2]河北省石家庄市第五医院感染科,河北石家庄050021 [3]河北省唐山市人民医院ICU,河北唐山063000

出　　处：《河北医科大学学报》2018年第6期649-652,共4页Journal of Hebei Medical University

基　　金：河北省医学科学研究重点课题(20181398)

摘　　要：目的观察别嘌呤醇对伴高尿酸血症糖尿病肾病患者血尿酸(serum uric acid,SUA)及尿蛋白排泄率(urinary albumin excretion rate,UAER)的影响。方法选取伴高尿酸血症糖尿病肾病患者160例作为研究对象,随机分为对照组及治疗组各80例,2组均接受常规治疗。对照组给予安慰剂1片,1次/d;治疗组给予别嘌呤醇0.1g,1次/d。检测2组治疗前后24h尿蛋白定量(24-hour urinary protein quantification,UTP)、UAER、血肌酐(serum creatinine,SCr)、高敏C反应蛋白(high-sensitive C-reactive protein,hs-CRP)、SUA、血糖(glucose,GLU)、血钾。结果治疗后,2组UTP、UAER、hs-CRP和SUA均明显低于治疗前,治疗组UTP、UAER、hs-CRP和SUA均低于对照组,差异有统计学意义(P<0.05);治疗后2组间及2组治疗前后SCr、血钾、GLU差异均无统计学意义(P>0.05)。结论别嘌呤醇可以有效降低伴高尿酸血症糖尿病肾病患者尿蛋白,其机制可能是通过对尿酸、胰岛素抵抗等的影响而减少尿蛋白排泄,可早期保护肾功能的损伤。Objective To observe the effects of allopurinol on serum uric acid（SUA） and urinary protein excretion of diabetic nephropathy（DN） patients with hyperuricemia.Methods One hundred and sixty DN patients with hyperuricemia were included in this study. They were randomly divided into control group（80 cases） and allopurinol group（80 cases）. Two groups of patients were given the conventional treatment of diabetes. The control group were given placebo and the treatment group were given allopurinol. 24 hour urine protein quantitative（UTP）, urinary albumin excretion rate（UAER）, SUA, high-sensitivity C-reactive protein（hs-CRP）, potassium, serum creatinine（SCr）, blood glucose were detected before and after treatment.Results UTP, UAER, hs-CRP, SUA of the patients in the two groups after treatment were decreased, and UTP, UAER, hs-CRP and SUA in treatment group were lower than those in control group, the difference was statistically significant（ P 〈 0.05）. After treatment, there was no significant difference in the SCr, potassium and GLU between 2 groups and the 2 groups before and after treatment（ P 〉 0.05）.Conclusion Allopurinol can effectively reduce urinary albumin excretion rate in diabetic nephropathy patients with hyperuricemia. The mechanism may be related to reduce urinary protein excretion through the effects of uric acid and insulin resistance, so as to protect renal function early.

关 键 词：糖尿病肾病 高尿酸血症 别嘌呤醇 

分 类 号：R587.24[医药卫生—内分泌]