CAJ | 학술논문

目的：探讨降低增高的血尿酸水平在心血管疾病防治中的贡献和意义。方法选取老年高血压合并糖尿病的高尿酸血症患者100例，均给予规范的药物治疗进行血压、血糖管理。根据患者意愿分为尿酸干预组（研究组）和对照组，研究组给予低嘌呤饮食及口服苯溴马隆片（剂量50 m g/日、疗程1年）。检测两组患者干预前后第3、6、12月血尿酸、糖化血红蛋白、空腹血糖、餐后2 h血糖等代谢产物变化及动态血压变化，随访期患者一级终点事件（全因死亡、总心血管死亡）发生情况。结果（1）研究组患者干预后第3、6、12月血尿酸水平明显低于干预前及对照组（ P＜0．01）。（2）研究组患者干预后第6、12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（P＜0．05）。（3）两组患者干预前、后各检测点的糖化血红蛋白、空腹血糖、餐后2 h血糖、血糖达标率等观察指标对比均无差异。（4）两组间全因死亡及总心血管死亡发生例数比较差异无统计学意义（P＞0．05）。结论降低老年高血压合并糖尿病的高尿酸血症患者病死/病残率的最关键措施，仍然是规范合理的血压管理和血糖管理。在此基础上，有效降低增高的血尿酸水平，可提高患者的血压达标率。
목적：탐토강저증고적혈뇨산수평재심혈관질병방치중적공헌화의의。방법선취노년고혈압합병당뇨병적고뇨산혈증환자100례，균급여규범적약물치료진행혈압、혈당관리。근거환자의원분위뇨산간예조（연구조）화대조조，연구조급여저표령음식급구복분추마륭편（제량50 m g/일、료정1년）。검측량조환자간예전후제3、6、12월혈뇨산、당화혈홍단백、공복혈당、찬후2 h혈당등대사산물변화급동태혈압변화，수방기환자일급종점사건（전인사망、총심혈관사망）발생정황。결과（1）연구조환자간예후제3、6、12월혈뇨산수평명현저우간예전급대조조（ P＜0．01）。（2）연구조환자간예후제6、12월동태혈압명현저우간예전급대조조，동태혈압체표솔고우간예전（P＜0．05）。（3）량조환자간예전、후각검측점적당화혈홍단백、공복혈당、찬후2 h혈당、혈당체표솔등관찰지표대비균무차이。（4）량조간전인사망급총심혈관사망발생례수비교차이무통계학의의（P＞0．05）。결론강저노년고혈압합병당뇨병적고뇨산혈증환자병사/병잔솔적최관건조시，잉연시규범합리적혈압관리화혈당관리。재차기출상，유효강저증고적혈뇨산수평，가제고환자적혈압체표솔。
Objective In order to discuss the contribution and significance of lowering increased serum uric acid levels in cardio-vascular disease prevention and control .Methods All 100 hyperuricemia in senile patients with hypertension and diabetes mellitus were received the standard drug treatments for bloodpressure ,blood sugar management .According to the patients′will divided them into uric acid intervention group(study group) and control group .The study group were given low purine diet and benzbromarone tablet (50 mg/day ,course of 1 year) ,then compare the changes between the 2 group and within each group after 3months ,6months and 1 years in the metabolism indexes before and after intervention (serum uric acid ,glycosylated hemoglobin ,fasting blood glu-cose ,2-hours postprandial glucose ,and the changes of dynamic blood pressure ) ,and follow-up the occurrence of cases in primary end point events (all-cause death ,total cardiovascular death) .Results (1)In study group ,3months ,6months and 1 years after in-tervention ,the serum uric acid lever was significantly lower than that before intervention and the control group ,P<0 .01 .(2)The study group patients′dynamic blood pressure was significantly lower than that before intervention and the control group after 6 ,12 months ,meanwhile the study group patients′success rate of dynamic blood pressure level is higher than themselves before the in-tervention after 6 ,12 months ,P<0 .05 .(3)The 2 groups of patients′glycosylated hemoglobin ,fasting plasma glucose ,2-hours post-prandial glucose ,control rate of blood glucose at each testing point before and after the intervention had no difference .(4)The oc-currence of cases between the 2 groups for all-cause death and total cardiovascular death had no difference .Conclusion (1)Reduc-ing the mortality and disability rate of hyperuricemia in elderly patients with hypertension and diabetes mellitus ,the most critical measures is still a reasonable standard blood pressure and blood sugar management .Based on this therapy ,effectively reducing the increased serum level of uric acid can improve the control rate of blood pressure .