| Objective To observe the effect of hyperuricemia on arterial elasticity and evaluate the short-term impact of allopurinol on arterial elasticity,high sensitive C reactive protein (hsCRP),uric acid(UA),blood pressure,blood glucose,blood lipids, liver and kidney function in patients with hyperuricemia,as well as the impact factors of arterial elasticity. Methods Select 59 patients with hyperuricemia (29～60 year, mean 46.24 year) and 28 patients without hyperuricemia(32～60 year, mean 49 year). Patients with hyperuriemia were randomly divided into allopurinol group(n=29) and control group(n=30) and treated for 3 months.The allopurinol group was given allopurinol O.lg 3 times/day and sodium bicarbonate 1.0g 3 times/day, control group was given sodium bicarbonate 1.0 3 times/day. Blood pressure, blood glucose, blood lipids, liver and kidney function, hsCRP, UA, brachial-ankle pulse wave velocity(baPWV) and ankle-brachial index(ABI)were observed before and after treatment,and the side effects of the drug.was also observed. Results (1)In hyperuricemia group, baPWV (1502.93±149.71 VS 1382.21±188.56,p<0.01)and hsCRP(4.66±2.40 VS 0.90±0.52,p<0.01)were significantly higher than that of non-hyperuricemia group. Correlation regression analysis showed that age(r=0.259,P<0.05),systolic blood pressure(r=0.409,P<0.01),hsCRP(r=0.357,P<0.01)associated with baPWV in hyperuricemia group.After adjusting for age, blood pressure, blood lipids, blood glucose, UA was the independent impact factor for baPWV(β=0.695,P<0.01).UA was significantly correlated with hsCRP(r=0.695,P<0.01).(2)A11 patients with hyperuricemia accomplished observation, no serious side effects happened. After treatment, in allopurinol group, systolic blood pressure(118.93±8.64 VS 127.73±10.27, p<0.01), diastolic blood pressure (77.24±8.24 VS 82.20±9.92, p<0.01),and hsCRP(1.1±0.71 VS 1.88±1.16,p<0.05)were significantly lower than that of the control group. (3)In allopurinol group, systolic blood pressure(118.93±8.64 VS 128.97±9.76, p<0.01), diastolic blood pressure (77.24±8.24 VS 80.62±6.52, p<0.01), hsCRP(1.11±0.71 VS 4.87±2.31,p<0.01),UA(386.68±102.92 VS 490.80±77.16,p<0.01),and baPWV (1384.48±126.15 VS 1524.48±139.49,p<0.01)decreased significantly after treatment. (4) In control group, hsCRP(1.88±1.16 VS4.45±2.51,p<0.01),UA(393.19±75.39 VS 455.36±82.93,p<0.01)decreased significantly after treatment, glomerular filtration rate(GFR)(63.77±14.45 VS 66.14±13.90,p<0.05)decreased after treatment. (5) Correlation analysis showed that the decrease of hsCRP(r=0.630,P<0.01)and UA (r=0.371,P<0.05)were associated with the baPWV derease. Allopurinol and decrease of hsCRP were independent impact factors of the baPWV by multiple stepwise regression analysis. Conclusion Patients with hyperuricemia had higher baPWV and hsCRP than patients without hyperuricemia which suggest that hyperuricemia was a chronic inflammatory state and a risk factor for early atherosclerosis.Allopurinol and sodium bicarbonate can reduce the level of the blood uric acid and hsCRP. With the decline in UA, the inflammation state can be improved.Allopurinol is safe and effective in the treatment of hyperuricemia,at the same time, allopurinaol can lower blood pressure and baPWV,improve blood vessel elasticity, reversing early atherosclerosis. The decline in baPWV was associated with the improvement of inflamation state, not depending on the change in UA. |
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