痛风患者血管内皮功能及颈动脉粥样硬化的临床研究

目的:观察痛风患者氧化应激指标与颈动脉内膜中层厚度(IMT)的变化,探讨高尿酸引起内皮功能损伤和颈动脉粥样硬化的机制。方法:选择痛风患者123例,正常健康者116例,检测两组患者血尿酸、细胞间粘附分子1(ICAM-1)、内皮素-1(ET-1)、一氧化氮(NO)、纤溶酶原激活抑制剂-1(PAI-1)、收缩压、舒张压、空腹血糖、HDL-C、LDL-C、TC、TG等糖、脂代谢指标及颈动脉内膜中层厚度(IMT)。分析痛风患者内皮损伤相关因子水平和颈动脉IMT的关系。结果:痛风组血清细胞间粘附分子1(ICAM-1)、内皮素-1(ET-1)、纤溶酶原激活抑制剂-1(PAI-1)水平较对照组增高,颈动脉IMT明显增厚,NO水平较对照组降低,差异均有统计学意义(P0.05)。血尿酸水平、ICAM-1、ET-1、PAI-1与IMT密切相关(P0.01)。结论:痛风患者较对照组存在更明显的代谢紊乱,血管内皮功能损伤,更易发生动脉粥样硬化。

Clinical Study of Endothelial Dysfunction and Carotid Atherosclerosis inPatients with Gout

Objective:To investigate the indicators of oxidative stress in patients with gout and carotid artery intima-mediathickness (IMT) changes and to explore the mechanism underlying high uric acid-caused endothelial dysfunction and carotidatherosclerosis.Methods:123 gout patients and 116 normal controls were enrolled in the study. Intercellular adhesion molecule-1(ICAM-1), endothelin-1 (ET-1), nitric oxide (NO), fibrinolysis plasminogen activator inhibitor-1 (PAI-1), systolic blood pressure,diastolic blood pressure, fasting glucose, HDL-C, LDL-C, TC, TG and carotid artery intima-media thickness (IMT) were measured in thetwo groups. And the relationship between endothelial dysfunction and carotid IMT was analyzed in patients with gout.Results:Theserum intercellular adhesion molecule-1 (ICAM-1), endothelin-1 (ET-1), and plasminogen activator inhibitor-1 (PAI-1) levels weresignificantly higher (P<0.01), the carotid IMT increased (P<0.01), and the NO level decreased (P<0.01) in gout patients compared withthose in the control group. Blood uric acid level, ICAM-1, ET-1 and PAI-1 were closely related to IMT.Conclusion:There are moresevere metabolic disorders and vascular endothelial dysfunction in gout patients than in the control group. Gout patients may be moresusceptible to atherosclerosis.