期刊文献+

尿酸干预对老年高血压合并糖尿病患者心功能的影响 被引量:7

Uric Acid Intervention Effect on Heart Function in Elderly Patients with Hypertension and Diabetes
下载PDF
导出
摘要 目的观察尿酸干预对高尿酸血症的老年高血压合并糖尿病患者心功能的影响,探讨降尿酸治疗能否成为一种心血管疾病防治的新方法.方法选择云南省第三人民医院2011年3月后高尿酸血症的老年高血压合并糖尿病患者100例,随机分为尿酸干预组和对照组,2组患者均规律服用降压药及降糖药干预组给予低嘌呤饮食及苯溴马隆片50 mg/d,定期每3月,6月及1 a随访观察2组患者代谢指标(血尿酸、空腹血糖、血尿素氮、血肌酐)及动态血压,同时对心功能进行评定,包括NYHA心功能分级,左室射血分数(LVEF),6 min步行距离(6MWD),血浆脑利钠肽(BNP)及因充血性心衰再住院例次.结果 (1)3月,6月及1 a后血尿酸干预组明显低于对照组,6月及1 a后动态血压干预组低于对照组(P<0.05);(2)干预组干预后3月,6月及1 a血尿酸及动态血压明显低于干预前(P<0.01),2组间及干预前后空腹血糖、血尿素氮、血肌酐比较差异无统计学意义(P>0.05);(3)1 a后干预组NYHA心功能分级,LVEF及6MWD较干预前及对照组提高,血浆脑利钠肽(BNP)较干预前及对照组降低,充血性心衰再住院例次及比例低于对照组,差异均有统计学意义(P<0.05).结论苯溴马隆片在有效降低血尿酸的同时能够降低血压,改善高尿酸血症的老年高血压合并糖尿病患者心功能.降尿酸治疗有望成为1种心血管疾病防治的新方法. Objective To observe uric acid intervention effect on cardiac function of elderly hyperuricemia patients with hypertensive and diabetes, and investigate the new method for cardiovascular disease prevention and control with dropping uric acid treatment. Methods 100 elderly hyperuricemia patients with hypertensive and diabetes in our hospital were selected from March 2011. They were randomly divided into uric acid intervention group and control group, and intervention group was given low purine diet and benzbromarone tablet 50 mg per day. Patients were followed up regularly at l, 3, 6 and 12 mouths to observe the metabolic indices (blood uric acid, fasting blood glucose, blood urea nitrogen and creatinine) and ambulatory blood pressure. At the same time cardiac function assessment was conducted, including NYHA classification, left ventricular ejection fraction (LVEF) , 6 minutes walking distance (6 MWD), plasma brain natriuretic peptide (BNP) and rehospitalizations for patients with congestive heart failure. Results (1) The blood uric acid level of the intervention group was significantly lower than that of the control group after 3, 6 and 12 months, and ambulatory blood pressure of intervention group was lower than that of control group after 6 and 12 months (P 〈 0.05) (2) In the intervention group, blood uric acid and ambulatory blood pressure have decreased significantly (P 〈 0.01) after intervention with uric acid for 3, 6 and 12 months. However, the differences of fasting blood glucose, blood urea nitrogen and creatinine in both groups and before and after intervention were not statistically significant. (3) After 1 year, NYHA cardiac function classification, LVEF and 6 MWD in the intervention group have improved compared with before intervention and control group, but plasma brain natriuretic peptide (BNP) have reduced. The number and proportion of rehospitalizations for patients with congestive heart failure in the intervention group were lower than those in the control group. There were significant differences of all indices (P 〈 0.05). Conclusion Benzbromarone tablet can effectively reduce blood uric acid and blood pressure at the same time, and can improve cardiac function of elderly hyperurieemia patients with hypertensive and diabetes. Dropping uric acid treatment is expected to become a new method for cardiovascular disease prevention and control.
出处 《昆明医科大学学报》 CAS 2013年第5期93-96,共4页 Journal of Kunming Medical University
基金 云南省科技厅应用基础研究面上项目(2010CD123)
关键词 尿酸 高尿酸血症 高血压病 心力衰竭 苯溴马隆片 Uric acid Hyperuricemia Hypertension disease Cardiac failure Benzbromarone tablet
  • 相关文献

参考文献9

  • 1DOEHNER W, ANKER S D. Uric acid in chronic heart f-ailure[ J]. Serain Nephrol,2005,25( 1 ):61 - 66.
  • 2STMTHERS A D,DONNAN P T,LINDSAY P,et al. E?fe-ects of allopurinol on mortality and hospitalisatiorts inchronic heart failure:a retrospective cohort study [j].Heart,2002,87(3 ):229-234.
  • 3ANKER S D,DOEHNER W,RAUCHHAUS M,et al. Uricacid and survival in chronic heart failure:validation and ap-plication in metabolic,functional,and hemodynamic staging[J]. Circulation,2003,107(15):1 991 - 1 997.
  • 4KANELLIS J,KANG D H. Uric acid as a mediator of en-dothelial dysfunction,inflammation,and vasculai disease[J]. Semin Nephrol,2005,25(1 ):39 - 42.
  • 5JOSHUA M’HARE RICHARD JJOHNSON.Uric acidpredicts clinical outcomes in heart failure:insights regard-ing the role of xanthine oxidase and Uric acid in diseasepathophysiology[j].Circulation,2003,107 : 1 951 - 1 953.
  • 6PASCUA-FIGAL D A,HURTADO-MARTINEZ J A,RE-DONDO B,et al. Hyperuricaemia and long-term outcomeafter hospital discharge in acute heart failure patients [j].Eur J Heart Fail,2007,9(5):518-524.
  • 7GAVIN A D,STRUTHERS A D. Allopurinol reduces B-t-ype natriuretie peptide concentrations and haemoglobin butdoes not alter exercise capacity in chronic heart failure[J]. Heart,2005,91 (6):749 - 753.
  • 8CLELAND J G,COLETRA A P,CLARK A L. Clinical tri-als up-date from the Heart Failure Society of Americameeting:FIX-CHF-4, selective cardiac myosin activator andOPT-CHF[J]. EurJ Heart Fail,2006,8(7):764 - 766.
  • 9邝健,麦炜颐,黄裕立,蔡安平,江志羔,王礼春,董吁钢,吴焱贤,胡允兆.别嘌醇治疗中青年高血压病合并高尿酸血症[J].中山大学学报(医学科学版),2009,30(6):762-766. 被引量:22

二级参考文献15

  • 1Mellen PB, Bleyer A J, Erlinger TP, et al. Serum uric acid predicts incident hypertension in a biethnic cohort: the atherosclerosis risk in communities study [J]. Hypertension, 2006, 48(6): 1037-1042.
  • 2Feig DI, Soletsky B, Johnson RJ. Effect of allopurinol on blood pressure of adolescents with newly diagnosed essential hypertension : a randomized trial [J]. JAMA, 2008, 300(8): 924-932.
  • 3Wang GT, Chung CC, Holzman TF, et al. A continuous fluorescence assay of renin activity [J]. Anal Biochem, 1993, 210(2): 351-359.
  • 4Birkenhager AM, van den Meiracker AH. Causes and consequences of a non-dipping blood pressure profile [J]. Neth J Med, 2007, 65(4): 127-131.
  • 5Li Y, Staessen JA, Lu L, et al. Is isolated nocturnal hypertension a novel clinical entity? Findings from a Chinese population study [J]. Hypertension, 2007, 50 (2) : 333-339.
  • 6Li LH, Li Y, Huang QF, et al. Isolated nocturnal hypertension and arterial stiffness in a Chinese population [J]. Blood Press Monit, 2008, 13(3): 157-159.
  • 7Staessen JA, Thijs L, Fagard R, et al. Predicting cardiovascular risk using conventional vs ambulatory blood pressure in older patients with systolic hypertension. Systolic Hypertension in Europe Trial Investigators [J]. JAMA, 1999, 282(6): 539-546.
  • 8Mazzali M, Hughes J, Kim YG, et al. Elevated uric acid increases blood pressure in the rat by a novel crystal-independent mechanism [J]. Hypertension,2001, 38(5): 1101-1106.
  • 9Sanchez-Lozada LG, Tapia E, Santamaria J, et al. Mild hyperuricemia induces vasoconstriction and maintains glomerular hypertension in normal and remnant kidney rats [ J]. Kidney Int, 2005, 67 ( 1 ) : 237-247.
  • 10de A Coutinho T, Turner ST, Kullo IJ. Serum uric acid is associated with microvascular function in hypertensive individuals [J]. J Hum Hypertens, 2007, 21(8): 610-615.

共引文献21

同被引文献53

引证文献7

二级引证文献28

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部