别嘌呤醇对慢性肾衰竭患者肾脏保护作用及机制

目的观察别嘌呤醇对慢性肾衰竭（CRF）患者肾功能的保护作用。方法将入选的86例CRF（除外尿酸性肾病）患者分成对照组和治疗组，对照组给予CRF常规非透析疗法治疗；治疗组则在对照组基础上加用别嘌呤醇治疗；观察4周。测定2组治疗前后患者的尿素氮（BUN）、血肌酐（SCr）、血尿酸、一氧化氮（NO），内皮素1（ET-1），血栓素B2（TXB2）、6-酮-前列腺素F1α（6-keto-PGF-1α）及超敏C反应蛋白（hs-CRP）。结果治疗组治疗后，BUN、SCr及血尿酸较同组治疗前显著降低（P〈0．05），与对照组比较有统计学差异（P〈0．05）；ET-1和NO分别较同组治疗前降低和升高（P〈0．05），TXB2和6-keto-PGF-1α分别较治疗前降低和升高（P〈0．05），hs-CRP较同组治疗前下降（P〈0．05），与对照组比较均有统计学差异（P〈0．05）。结论别嘌呤醇对CRF患者肾功能具有保护作用，其可能是通过抗微炎症状况和改善血管内皮功能的作用。

Effects of allopurinol on kidney in patients with chronic renal failure and protective mechanism

Objective To investigate the effects of allopurinol on kidney in patients with chronic renal failure,and discuss the possible mechanism. Methods Eighty-six cases of chronic renal failure having no gout-induced nephropathy were divided into two groups randomly： control group receiving conventional un-hemodialysis therapy; treatment group receiving conventional treatment combined with allopurinol treatment. The treatment duration was 4 weeks. The BUN, SCr, HA, NO, ET, TXB2 and 6-keto-PGF-la were determined before and after treatmentl. Results After treatment, the levels of BUN, SCr and uric acid were significantly lower than those before the treatment and control group （all P~0. 05）. The levels of EG, TXB2 and hs-CRF in treatment group were reduced, and those of NO and 6-keto-PGF-1 a were increased as compared with those before the treatment and control group （all P% 0. 05）. Conclusions Allopurinol can protect the renal function of patients with chronic renal failure by antagonizing vasculitis and improving function of vascular endothelial cells.