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别嘌醇对充血性心力衰竭患者心功能的影响(PDF)

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2004年第5期
页码:
452-453,456
栏目:
临床研究
出版日期:
2004-09-01

文章信息/Info

Title:
Effects of Allopurinol on cardiac function in patients with congestive heart failure
作者:
肖立中; 江志平; 黄　志; 徐　新; 潘丽坤; 赖少燕; 曾兆俞
广东省粤北医院心内科,广东韶关512026
Author(s):
XIAO Li-zhong ;  JIANG Zhi-ping ;  HUANG Zhi ;  XU Xin ;  PAN Li-kun ;  LAI Shao-yan ;  ZENG Zhao-yu
Department of Cardiology , Yuebei Hospital , Shaoguan , Guangdong 512026 , China
关键词:
高尿酸血症; 别嘌醇; 心力衰竭;  充血性; 心功能; 一氧化氮; 活性氧族
Keywords:
hyperuricemia ; Allopurinol ; congestive heart failure ; cardiac function ; nitric oxide ; reactive oxygen species
分类号:
R541. 61
DOI:
-
文献标识码:
A
摘要:
目的:观察别嘌醇对充血性心力衰竭(CHF) 患者心功能的影响。方法:选择CHF 伴高尿酸血症患者45 例,随 机分为常规治疗组和别嘌醇组,后者在常规治疗基础上合用别嘌醇0. 4 g/ d ,疗程12 周。采用心脏彩色多普勒超声 测定左室射血分数(LVEF) 、左室收缩末容量指数(LVESVI) ,同时测定血浆丙二醛、一氧化氮。结果:别嘌醇组血浆 丙二醛明显降低、一氧化氮增加( P < 0. 01) ,LVEF 增加、LVESVI 降低( P < 0. 05) ,LVEF、LVESVI 的变化与丙二醛降低 相关( r = - 0. 42 , 0. 45 , P < 0. 05) ,与一氧化氮增加无相关关系( r = 0. 32 , - 0. 34 , P > 0. 1) 。结论:别嘌醇改善 CHF 伴高尿酸血症患者心功能,可能与减少活性氧族有关。
Abstract:
AIM:To observe the effect of Allopurinol on cardiac function in patients with congestive heart failure . METHODS: 45 hyperuricemic patients with congestive heart failure were randomly divided into two groups ; one group ( n = 23) received Allopurinol 0. 4g/ d plus routine theraphy , and the other group ( n = 22) received routine theraphy only. Before and after the 12-week therapy , plasma malondialdehyde , nitric oxide level were assayed , left ventricular ejection fraction (LVEF) , left ventricular end systolic volume index (LVESVI) were measured by Echo - Doppler. RESULTS :After the 12-week therapy with Allopurinol , plasma malondialdehyde was decreased , nitric oxide was increased ( P < 0. 01) , LVEF increased and LVESVI decreased ( P < 0. 05) . LVEF and △LVESVIwere correlated to the decrease of malondialdehyde ( r = - 0. 42 , 0. 45 respectively , P < 0. 05) , but not correlated to the increase of nitric oxide ( r = 0. 32 , - 0. 34 respectively , P > 0. 1) . CONCLUSION:Allopurinol improves cardiac function in hyperuricemic patients with congestive heart failure , which may be due to the decrease in reactive oxygen species.

参考文献/References

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[2 ] Cicoira M, Zanolla L , Rossi A , et al . Elevated serum uric acid levels are associated with diastolic dysfunction in patients with dilated cardiomyopathy[J ] . Am Heart J , 2002 , 143 (6) : 110721111.

[3 ] Struthers AD , Donnan PT , Lindsay P , et al . Effect of allopurinol on mortality and hospitalisations in chronic heart failure : a retrospective cohort study[J ] . Heart , 2002 , 87 (3) : 229 - 234.

[4 ] Maack C , Kartes T , Kilter H , et al . Oxygen free radical release in human failing myocardium is associated with increased activity of Rac1 -GTPase and represents a target for statin treatment [J ] . Circulation ,2003 , 108 (13) :1567 - 1574.

[5 ] Saavedra WF , Paolocci N , St John ME , et al . Imbalance between xanthine oxidase and nitric oxide synthase signaling pathways underlies mechanoenergetic uncoupling in the failing heart [J ] . Circ Res , 2002 , 90(3) : 297 - 304.

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[7 ] 肖立中, 江志平,黄　志,等. 别嘌醇对冠心病患者内皮功能及心功能的影响[J ] . 中国循环杂志, 2003 , 18 (1) : 16 - 18.

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[9 ] 丁　钢, 左春梅, 黄永麟. 一氧化氮在心肌缺血再灌注时对心肌功能的影响[J ] . 心脏杂志, 1999 , 11 (3) : 194 - 196.

[10 ]Cotton JM, Kearney MT , Shah AM. Nitric oxide and myocardial function in heart failure : friend or foe ? [J ] . Heart , 2002 , 88 (6) : 564 -566.

备注/Memo

备注/Memo:
收稿日期：2003-10-18
更新日期/Last Update: 2004-09-01