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目的观察不稳定型心绞痛并高尿酸血症患者应用别嘌呤醇治疗的疗效和安全性。方法 79例不稳定型心绞痛并高尿酸血症患者随机分为观察组41例和对照组38例,对照组给予常规治疗,观察组在常规治疗基础上口服别嘌呤醇,初始剂量为50mg/次,2次/d,每周递增50mg/次,至200mg/次,2次/d,维持;2组疗程均为3个月。比较2组治疗后心肌梗死溶栓疗法(the Thrombolysis in Myocardial Infarction,TIMI)危险评分、全球急性冠状动脉事件注册(Global Registry of Acute Coronary Events,GRACE)评分、心绞痛分级及血尿酸水平,记录治疗后心电图运动负荷试验ST最大压低水平、运动开始至终止时间、运动最快心率,观察2组不良反应发生情况。结果观察组治疗后TIMI评分(2.2±0.9)、GRACE评分(76.3±22.8)和血尿酸水平((354.6±31.3)μmol/L)低于治疗前(3.2±1.2、104.6±30.1、(477.6±26.4)μmol/L)(P<0.05)和对照组治疗后(2.7±1.1、88.5±23.9、(459.9±33.2)μmol/L)(P<0.05);观察组治疗后心绞痛分级改善较治疗前和对照组明显(P<0.05);观察组治疗3个月后ST最大压低水平((-0.81±0.26)mV)、运动开始至终止时间((313.2±54.3)s)、运动最快心率((129.2±18.4)次/min)与对照组((-0.94±0.30)mV、(275.5±48.9)s、(116.2±15.2)次/min)比较差异均有统计学意义(P<0.05);2组均未发生明显药物不良反应,观察组上腹部隐痛发生率(14.6%)与对照组(13.2%)比较差异无统计学意义(P<0.05)。结论不稳定型心绞痛并高尿酸血症患者在常规治疗基础上应用别嘌呤醇可减轻患者心肌缺血、增加患者活动耐力,改善心绞痛程度,且不良反应轻。
Objective To observe the efficacy and safety of allopurinol in patients with unstable angina and hyperuricemia. Methods A total of 79 patients with unstable angina pectoris and hyperuricemia were randomly divided into observation group (n = 41) and control group (n = 38). The control group was given routine treatment. The observation group was given oral allopurinol on the basis of routine treatment. The initial dose was 50mg , 2 times / d, increasing 50mg / times weekly, to 200mg / time, 2 times / d, maintaining; 2 courses of treatment were 3 months. The Thrombolysis in Myocardial Infarction (TIMI) risk score, Global Registry of Acute Coronary Events (GRACE) score, angina pectoris grade and serum uric acid level were compared between the two groups. After treatment, Electrocardiogram exercise stress test ST the maximum level of depression, movement start to end time, the fastest heart rate, observed two groups of adverse reactions. Results The TIMI score (2.2 ± 0.9), GRACE score (76.3 ± 22.8) and serum uric acid level (354.6 ± 31.3) μmol / L in the observation group were lower than those before treatment (3.2 ± 1.2,104.6 ± 30.1, 477.6 ± 26.4) μmol / L) and control group (2.7 ± 1.1,88.5 ± 23.9, (459.9 ± 33.2) μmol / L respectively) (P <0.05) (P <0.05). After 3 months of treatment, the maximal depression of ST was (-0.81 ± 0.26) mV, the beginning to the end of exercise was (313.2 ± 54.3) s), the fastest heart rate was (129.2 ± 18.4) times / min) were significantly different from those in the control group (-0.94 ± 0.30 mV, (275.5 ± 48.9) s, (116.2 ± 15.2) / min) No significant adverse drug reactions occurred in the two groups. The incidence of upper abdominal pain (14.6%) in the observation group was not significantly different from that in the control group (13.2%) (P <0.05). Conclusion Allopurinol in patients with unstable angina and hyperuricemia on the basis of conventional treatment can reduce myocardial ischemia, increase patient activity endurance, improve the degree of angina pectoris, and mild adverse reactions.