干预血尿酸水平对老年高血压合并糖尿病患者心脏事件的影响

发布时间：2018-09-10 15:09

【摘要】：目的探讨干预血尿酸(UA)水平对老年高血压合并糖尿病患者心脏事件的影响。方法选取老年高血压合并糖尿病的高UA血症患者100例,均给予规范的药物治疗进行血压、血糖管理。根据患者意愿分为研究组(UA干预组)和对照组,干预组给予低嘌呤饮食及口服苯溴马隆片(剂量50 mg/d、疗程1年)。检测两组患者干预前后第3、6、12个月血UA、糖化血红蛋白(HbA1c)、空腹血糖(FPG)、餐后2 h血糖(2 h PG)等代谢产物变化及动态血压变化,随访期患者非致死性心肌梗死、心绞痛发生情况。结果 1研究组患者干预后第3、6、12个月血UA水平明显低于干预前及对照组(均P0.01)。2研究组患者干预后第6、12个月动态血压明显低于干预前及对照组,动态血压达标率高于干预前(均P0.05)。3两组患者干预前后各检测点的HbA1c、FPG、2 h PG、血糖达标率等观察指标对比均无显著差异(P0.05)。4研究组干预后第12个月心绞痛发生例次及比例低于对照组(P0.05);两组间非致死性心肌梗死发生例次及比例无显著差异(P0.05)。结论存在高UA血症的老年高血压合并糖尿病患者,有效降低增高的血UA水平,可提高其血压达标率,进而改善患者临床心脏事件的转归。
[Abstract]:Objective to investigate the effect of intervention of serum uric acid (UA) on cardiac events in elderly patients with hypertension and diabetes mellitus. Methods 100 elderly patients with hypertension and diabetes mellitus were treated with standardized drug therapy for blood pressure and blood glucose management. According to the wishes of the patients, the patients were divided into study group (UA intervention group) and control group. The intervention group was given low purine diet and oral benzbromarone tablet (50 mg/d, for 1 year). Serum UA, glycosylated hemoglobin (HbA1c), fasting blood glucose (FPG),) 2 h postprandial blood glucose (2 h PG) and ambulatory blood pressure (ABBP) were measured before and after intervention. The patients were followed up with non-fatal myocardial infarction and angina pectoris. Results 1 the serum UA levels in the study group were significantly lower than those in the control group and the control group at the 6th and 12th month after intervention (P0.01). The mean ambulatory blood pressure (ABBP) was significantly lower in the study group than in the control group at the 6th and 12th months after intervention. There was no significant difference in the HbA1c,FPG,2 h PG, blood glucose reach standard rate between the two groups before and after intervention (P0.05). 4. The incidence and proportion of angina pectoris in the study group at the 12th month after intervention were higher than those before and after intervention (P0.05). Compared with the control group (P0.05), there was no significant difference between the two groups in the incidence and proportion of non-fatal myocardial infarction (P0.05). Conclusion in elderly patients with hypertension complicated with diabetes mellitus with high UA, it is effective to reduce the increased level of blood UA, improve the blood pressure to achieve the standard rate, and then improve the outcome of clinical cardiac events in the patients.
【作者单位】：云南省第三人民医院老年病科;
【基金】：云南省科技厅云南省应用基础研究面上项目(2010CD123)
【分类号】：R544.1;R587.1

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