2018 年第 5 期 第 13 卷

小剂量阿司匹林对急性冠状动脉综合征患者血尿酸水平及肾功能的影响

Effect of low-dose aspirin on serum uric acid level and renal function in patients with acute coronary syndrome

作者：杨丽娟矫杰孙秀芹陶红

英文作者：

单位：100029首都医科大学附属北京安贞医院内分泌代谢科

英文单位：

关键词：急性冠状动脉综合征；阿司匹林；高尿酸血症；肾小球滤过率

英文关键词：

• 摘要：

• 目的    观察小剂量阿司匹林对急性冠状动脉综合征(ACS)患者血尿酸水平及肾功能的影响。方法    回顾性分析2016年1月至2017年6月在首都医科大学附属安贞医院内分泌代谢科就诊的100例ACS患者的临床资料。根据抗血小板治疗方案的不同分为观察组及对照组，每组50例，性别及年龄相匹配。2组患者进行基础疾病治疗，观察组服用小剂量阿司匹林肠溶片100 mg/d，对照组服用硫酸氢氯吡格雷75 mg/d。入组前所有患者查血尿酸及肌酐水平作为基线对照，比较2组患者治疗前及治疗3、6个月时血尿酸、血肌酐水平及肾小球滤过率。结果    2组患者治疗前血尿酸、血肌酐水平及肾小球滤过率差异均无统计学意义(均P>0.05)。观察组治疗3、6个月后血尿酸水平高于治疗前［（376±60）、（378±69）μmol/L比（339±40）μmol/L］及对照组［（339±45）、（340±49）μmol/L］，差异均有统计学意义(均P<0.05)。治疗6个月后，观察组血肌酐水平高于、肾小球滤过率低于治疗前及对照组［（88±18）μmol/L比（77±18）、（78±17）μmol/L，（77±20）ml/(min·1.73 m2)比（92±20）、（90±20）ml/(min·1.73 m2)］，差异均有统计学意义(均P<0.05)。结论    小剂量阿司匹林会导致血尿酸水平增加，甚至导致高尿酸血症，同时会影响肾小球滤过率；对于需要服用小剂量阿司匹林抗血小板治疗的患者应及时监测血尿酸及肾功能，权衡利弊，调整治疗。

• 【Abstract】Objective    To observe the effect of low-dose aspirin on serum uric acid level and renal function in patients with acute coronary syndrome(ACS). Methods    Clinical records of 100 ACS patients admitted from January 2016 to June 2017 in Beijing Anzhen Hospital, Capital Medical University were reviewed; the patients were divided into observation group and control group(age and sex matched, n＝50) according to different antiplatelet treatments; the observation group took aspirin enteric-coated tablets 100 mg/d and the control group took hydrogen clopidogrel sulfate 75 mg/d. Serum levels of uric acid and creatinine and glomerular filtration rate were analyzed before and 3, 6 months after treatment. Results    There were no significant differences of serum uric acid level, creatinine level and glomerular filtration rate between groups before treatment(P>0.05). Serum uric acid level 3, 6 months after treatment in observation group were significantly higher than those before treatment［（376±60）,（378±69）μmol/L vs （339±40）μmol/L］ and those in control group［（339±45）,（340±49）μmol/L］(P<0.05). Serum creatinine level 6 months after treatment in observation group was significantly higher and glomerular filtration rate was significantly lower than those before treatment and those in control group［（88±18）μmol/L vs （77±18）,（78±17）μmol/L; （77±20）ml/(min·1.73 m2) vs （92±20）,（90±20）ml/(min·1.73 m2)］(P<0.05). Conclusion    Low-dose aspirin treating acute coronary syndrome may cause hyperuricemia and reduce glomerular filtration rate.

  【Key words】Acute coronary syndrome;Aspirin;Hyperuricemia;Glomerular filtration rate

  【Fund program】High Level Health Technical Personnel Training Project of Beijing Health System(2013-3-008)