CAJ | 학술논문

目的：别嘌醇在慢性肾脏病进展与心血管危险中的作用。方法选择门诊慢性肾脏病患者135例，随机化分为对照组和治疗组。治疗组患者给予别嘌醇治疗。降压药物、降脂药物和抗血小板药物，均先维持原剂量不变。对照组患者不使用别嘌醇治疗。分别观察两组患者治疗6个月、12个月和24个月时血压、血尿酸、超敏 C 反应蛋白、胱抑素-C 和肾小球滤过率(eGFR)的变化。记录患者治疗期间心血管事件的发生率。结果两组患者一般资料比较无差异，治疗组血尿酸浓度、 hs-CRP 浓度和胱抑素-C 浓度在治疗后6个月、12个月和24个月时显著低于治疗前水平(P<0.05)，组间比较也显著低于对照组水平(P<0.05)，治疗组在随访12个月和24个月时 eGFR 显著高于对照组(P<0.05)。别嘌醇的治疗可将心血管事件的发生危险降低71%(P=0.026)。结论别嘌醇的治疗，可减少炎症反应，并延缓中度 CKD 患者中肾脏病的进展，此外别嘌醇还可减少心血管危险。
목적：별표순재만성신장병진전여심혈관위험중적작용。방법선택문진만성신장병환자135례，수궤화분위대조조화치료조。치료조환자급여별표순치료。강압약물、강지약물화항혈소판약물，균선유지원제량불변。대조조환자불사용별표순치료。분별관찰량조환자치료6개월、12개월화24개월시혈압、혈뇨산、초민 C 반응단백、광억소-C 화신소구려과솔(eGFR)적변화。기록환자치료기간심혈관사건적발생솔。결과량조환자일반자료비교무차이，치료조혈뇨산농도、 hs-CRP 농도화광억소-C 농도재치료후6개월、12개월화24개월시현저저우치료전수평(P<0.05)，조간비교야현저저우대조조수평(P<0.05)，치료조재수방12개월화24개월시 eGFR 현저고우대조조(P<0.05)。별표순적치료가장심혈관사건적발생위험강저71%(P=0.026)。결론별표순적치료，가감소염증반응，병연완중도 CKD 환자중신장병적진전，차외별표순환가감소심혈관위험。
Objective To observe the effect of allopurinol in chronic kidney disease progression and cardiovascular risk. Meth-ods 135 outpatients with chronic kidney disease were randomly divided into the treatment group and the control group. Patients in the treatment group were treated with allopurinol. Antihypertensive drugs, lipid-lowering agents and antiplatelet drugs maintained the origi-nal constant dose. Patients in the control group continued to receive the usual therapy. Respective observation was made of the changes in blood pressure, blood uric acid, hypersensitive c-reactive protein, bladder inhibition-C and glomerular filtration rate (eGFR) in the two groups of patients in a 6, 12 and 24 months. The incidence of patients’ cardiovascular events got recorded during treatment. Results There is no difference in the general data of the two groups of patients. After treatment of 6 , 12 and 24 months, the hs CRP, blood uric acid concentration as well as inhibition-C concentration in the treatment group were significantly lower than before (P<0. 05). Comparison within groups was also significantly lower than the control group (P<0. 05). eGFR of the treatment group in the follow-up for 12 months and 24 months was significantly higher than that of the control group (P<0. 05). Allopurinol can reduce the risk of cardiovascular events by 71% compared with normal therapy. (P= 0. 026). Conclusion Allopurinol can reduce the inflam-matory response and slow down the progression of renal disease in patients with chronic kidney disease. In addition, allopurinol can re-duce cardiovascular risk in these subjects.