控制高尿酸血症与血管内皮功能的临床研究

目的本研究观察高尿酸血症与内皮功能的关系.方法体检正常者302人,均经过病史、体检及化验证实无症状性冠心病、症状性脑血管病、高血压、糖尿病、血脂代谢紊乱等影响内皮功能者. 检测302人的血尿酸水平,其中56例阳性者为病例组,在阴性者中取56例为对照组,两组之间采用配对设计,匹配非处理因素,比较两组中血管内皮功能相关指标.结果高尿酸血症阳性组内皮功能相关指标一氧化氮(NO)水平明显低于对照组(t=-3.06,P=0.016),假血友病因子(vWF)水平明显高于对照组(t=2.63,P=0.03),血流介导的血管扩张(FMD),阳性组明显低于对照组(t=-3.85,P=0.005).两组比较,差异具有统计学意义(P<0.001).给予严格的饮食控制4周,内皮功能改善.结论高尿酸血症可引起内皮功能紊乱,由此可发展为动脉硬化.饮食控制可改善内皮功能.

Clinical study between controling hyperuricemia and endothelial function

Objective To clarify the relationship between hyperuricemia and endothelial function.Methods Serum uric acid was tested in healthy 302 persons who did not show symptoms of coronary disease,hypertension,diabetes and hyperlipmia through body check.Among them,56 cases with positive hyperuricemia served as patients' or positive group,another 56 cases with negative hyperuricemia as normal or negative group.In addition,the levels of nitric oxide(NO,nitrate method),von Willebrand factor(vWF,enzyme linked immunosorbent assay) and flow-mediated dilatation(FMD) were measured.Results NO level and FMD in hyperuricemia patients were significantly lower(t=(-3.06),P=(0.016);t=(-3.85),P=(0.005)),whereas the level of vWF in patients' group was significantly higher than that in normal group(t=(2.63),P=(0.03))(both P<(0.001)).In addition, there was a positive correlation between body mass index,low density lipoprotein cholesterol,triglycerides and the level of serum uric acid,whereas the correlation between the high density lipoprotein cholesterol and serum uric acid was negative.Lastly subtract concomitant variable linearity effect.The levels of NO,vWF and FMD in positive group and in negative group still showed significant difference.Strict diet control for four weeks improved endothelial dysfunction.Comclusions Hyperuricemia induces an endothelial dysfunction,which may trigger the development of atherosclerosis later on.Diet control improves endothelial dysfunction.