非布司他联合前列地尔冶疗慢性肾脏病伴高尿酸血的临床疗效

Effect of Febuxostat Combined with Alprostadil on Renal Functions and Uric Acid Levels in Patients with Chronic Kidney Disease and Hyperuricemia

目的:探讨非布司他与前列地尔联合治疗对慢性肾脏病伴高尿酸血症患者肾功能以及尿酸水平的改善效果。方法:回顾性分析2015年4月—2018年2月在我院治疗的106例慢性肾脏病伴高尿酸血症患者的临床资料,依据治疗方案的不同分为对照组与观察组,各53例,对照组给予非布司他(40 mg,qd),观察组给予非布司他(同对照组)+前列地尔(10μg溶于20 mL0.9%氯化钠注射液中,静脉推注,qd)],比较两组治疗前后肾功能指标[尿素氮(blood urea nitrogen,BUN)、血肌酐(serum creatinine,Scr)、白蛋白(albumin,Alb)、尿微量白蛋白(microalbuminuria,U-mAlb)]以及血清尿酸水平。结果:治疗前两组Scr、BUN、Alb以及U-mAlb水平比较,差异无统计学意义(P> 0.05);治疗8周后观察组Scr、BUN、U-mAlb水平均低于对照组,Alb水平高于对照组,差异有统计学意义(P <0.05);治疗前两组尿酸水平比较,差异无统计学意义(P> 0.05);治疗8周后观察组尿酸水平低于对照组,差异有统计学意义(P <0.05)。结论:非布司他与前列地尔联合治疗慢性肾脏病伴高尿酸血症可有效延缓或者逆转肾功能进展,利于降低尿酸水平,促进疾病良好转归。

Objective:To investigate the effect of febuxostat combined with alprostadil on renal functions and uric acid levels in patients with chronic kidney disease and hyperuricemia.Methods:The clinical data of 106 patients with chronic kidney disease and hyperuricemia admitted to our hospital from April 2015 to February 2018 were retrospectively analyzed.According to the different treatment regimens,the patients were divided into a control group and an observation group,53 cases each.The patients in the control group were treated with febuxostat(40 mg,qd),while the patients in the observation group were treated with febuxostat(the same as the control group)plus alprostadil(10μg drug was dissolved in 20 mL 0.9%sodium chloride injection,intravenous bolus,qd).The renal function indexes[blood urea nitrogen(BUN),serum creatinine(Scr),albumin(Alb),microalbuminuria(U-mAlb)]and serum uric acid levels before and after treatment were compared between the two groups.Results:There were no statistically significant differences in the levels of Scr,BUN,Alb and U-mAlb between the two groups before treatment(P>0.05).After 8 weeks of treatment,the levels of Scr,BUN and U-mAlb in the observation group were lower than those in the control group,while the level of Alb was higher than that in the control group,with statistically significant difference(P<0.05).There was no statistically significant difference in the level of uric acid between the two groups before treatment(P>0.05).After 8 weeks of treatment,the level of uric acid in the observation group was lower than that in the control group,and the difference was statistically significant(P<0.05).Conclusion:Febuxostat combined with alprostadil can effectively delay or reverse the progression of renal functions in the treatment of chronic kidney disease with hyperuricemia,help to reduce the level of uric acid and promote good outcomes.