痛风发病年龄特征及降尿酸治疗对内皮功能影响.docVIP

痛风发病年龄特征及降尿酸治疗对内皮功能影响 　　[摘要] 目的 探讨痛风的发病年龄特征及降尿酸治疗对血管内皮功能的影响。 方法 回顾性分析我院2007年1月～2016年12月住院和门诊的231例痛风患者，选择其中72例患者随机分成两组（n=36），一组口服非布司他，一组口服别嘌呤醇，治疗前及治疗后12周行彩色多普勒超声检查内皮依赖性血管舒张功能。 结果 （1）60岁发病组痛风患者合并症发生率最高的是高血压病、肾脏病变、冠心病和脑血管病，其低密度脂蛋白、胆固醇、甘油三酯、尿酸水平最低。（2）降尿酸治疗12周后两组肱动脉内皮依赖性血管舒张功能增强（P0.05）。 结论 高龄发病的患者高血压病、肾病、冠心病和脑血管病的合并症发生率高。降尿酸治疗能改善患者血管内皮功能。 　　[关键词] 痛风；发病年龄；降尿酸治疗；内皮功能 　　[中图分类号] R589.6 [文献标识码] A [文章编号] 1673-9701（2017）28-0008-04 　　[Abstract] Objective To investigate the characteristics of onset age of gout and the effect of urate-lowering therapy on endothelial function. Methods 231 patients with gout who were hospitalized and diagnosed in outpatient clinic in our hospital from January 2007 to December 2016 were retrospectively analyzed. 72 patients were randomly divided into two groups（n=36）. One group was orally given febuxostat， and the other group was orally given allopurinol. Before and after treatment， color Doppler ultrasonography was used to examine endothelium-dependent vasodilatation 12 weeks after treatment. Results （1）The complications with the highest incidence rate in the patients with gout more than 60 years old in the onset group： hypertension， renal disease， coronary heart disease and cerebrovascular disease， and the low density lipoprotein， cholesterol， triglyceride， and uric acid levels were the lowest. （2）The endothelium-dependent vasodilatation function in brachial artery was enhanced 12 weeks after urate-lowering therapy（P0.05）. Conclusion The incidence rate of complications of hypertension， nephropathy， coronary heart disease and cerebrovascular disease in the elderly patients is high. Urate-lowering therapy can improve the patients vascular endothelial function. 　　[Key words] Gout； Onset age； Urate-lowering therapy； Endothelial function 　　痛?L（Gout）是嘌呤代谢障碍引起的代谢性疾病，常与肥胖、糖脂代谢紊乱、高血压、动脉硬化和冠心病等聚集发生相关。已有研究表明对血尿酸水平增高的患者应用别嘌呤醇阻断氧化应激可以改善其血管内皮功能，降低心血管事件发生率[1]。为了解痛风的发病年龄特征及降尿酸治疗对血管内皮功能的影响，本文对231例痛风患者进行临床分析，并从中纳入72例复诊患者行降尿酸治疗并检测血管内皮功能，现报道如下。 　　1 资料与方法 　　1.