摘要
目的 :观察别嘌呤醇对冠心病并高尿酸血症患者内皮依赖性血管舒张功能及心功能的影响。方法 :选择经冠状动脉造影确诊为冠心病的患者 71例 ,对其中 46例冠心病并高尿酸血症患者随机分成两组 (各组n =2 3 ) ,别嘌呤醇组给予别嘌呤醇 0 4g/d ,安慰剂组给予谷维素 60mg/d ;另 2 5例冠心病尿酸正常患者为尿酸正常组 ,给予别嘌呤醇 0 4g/d ,均观察 4周 ,采用高精度血管超声技术检测肱动脉内皮依赖性血管舒张功能及心脏彩色多普勒超声测定左心室舒张功能指标 :舒张早期峰值速度 /舒张晚期峰值速度 (E/A)、峰减速时间、峰减速率 ;收缩功能指标 :左心室射血分数、左心室短轴内径缩短率 ,同时测定血清尿酸、血浆丙二醛水平。结果 :仅别嘌呤醇组治疗后较治疗前比较血清尿酸、血浆丙二醛水平降低 ,肱动脉内皮依赖性血管舒张功能增强 ,均有极显著性差异 (P <0 0 1) ,E/A、峰减速率增加 ,均有显著性差异 (P <0 0 5及P <0 0 1) ,左心室射血分数、左心室短轴内径缩短率有增加趋势 (P >0 0 5 ) ,但未达到统计学显著性。Δ血清尿酸与Δ肱动脉内皮依赖性血管舒张功能、ΔE/A、Δ峰减速率负相关 ,相关系数分别为 -0 47、-0 3 9、-0 41(P <0 0 5 ) ,与Δ射血分数、Δ短轴内径缩短率相关系数分别为 -0 2 9、-0
Objective:To observe the effect of allopurinol on endothelial function and cardiac function in patients with coronary heart disease(CHD) and hyperuricemia. Methods: Forty six hyperuricemic CHD patients randomly received allopurinol 0 4/d(allopurinol group)or oryzanol 60 mg/d (control group),twenty five CHD patients with normal serum uric acid received allopurinol 0 4/d (normal serum uric acid group) for 4 week therapy. Before and after the treatment, serum uric acid(UA) and plasma malondialdehyde levels were assayed by biochemical assay.Brachial artery flow mediated dilatation (FMD) function was measured by high resolution vascular ultrasonography. E/A ratio, E wave deceleration velocities(DC) for left ventricular diastolic function and left ventricular ejection fraction (LVEF),fractional shortening(FS)for systolic function were measured by Echo Doppler.Results: Only in allopurinol group,the serum uric acid and plasma malondialdehyde levels were decreased. FMD was improved ( p <0 01), E/A ratio and E wave deceleration velocities increased( p <0 05). LVEF and FS increased ( p >0 05). There was a negative correlation between ΔUA and ΔFMD?ΔE/A?ΔDC, γ=-0 47?-0 39?-0 41, respectively( p <0 05),no correlation found between ΔUA and ΔEF?ΔFS, γ=-0 29?-0 25,respectively( p >0 05)?Conclusion:Allopurinol improves endothelial function and left ventricular diastolic function and tends to improve systolic function in patients with coronary heart disease and hyperuricemia.
出处
《中国循环杂志》
CSCD
北大核心
2003年第1期16-18,共3页
Chinese Circulation Journal
