慢性肾脏病患者高尿酸血症的治疗及效应

Treatment of hyperuricemia in chronic kidney disease patients and its effect

目的观察慢性肾脏病患者高尿酸血症的治疗及效应。方法98例合并高尿酸血症的慢性肾脏病患者随机分为两组,治疗组给予别嘌呤醇控制高尿酸血症,对照组不给予别嘌呤醇,定期随访6个月。在基线及随访期间检测临床及血生化指标。结果共有86例患者完成随访。6个月后,治疗组血清尿酸显著下降。治疗组收缩压、舒张压较基线显著下降。治疗组肾功能较基线显著改善(血清肌酐112±22μmol/Lvs119±27μmol/L,肾小球滤过率53.8±13.7ml/minvs51.1±13.4ml/min),而对照组肾功能显著下降。治疗组与对照组6个月时的血清肌酐(t=2.104,P=0.038)及肾小球滤过率(t=2.120,P=0.037)之间均有显著差异。两组的24小时尿蛋白、血清超敏C反应蛋白无显著改变。结论别嘌呤醇治疗可控制早中期慢性肾脏病患者的高尿酸血症,并有助于改善肾功能。

Objective To observe the treatment of hyperuricemia in chronic kidney disease patients and its effect. Methods 98 hyperuricemic chronic kidney disease patients were randomly assigned to treatment group with allopurinol to control hyperuricemia or to control group without allopurinol. Patients were followed up for 6 months. Clinical and biochemical parameters were measured at baseline and during the follow-up. Results A total of 86 patients completed the follow-up. Serum uric acid levels were significantly decreased in the treatment group.There were significant decreases in systolic blood pressure and diastolic blood pressure in the treatment group. Serum creatinine and glomerular filtration rate levels significantly improved in the treatment group （serum creatinine112±221μmol/L vs 119±27μmol/L,glomerular filtration rate 53.8±13.7ml/min vs 51.1± 13.4ml/min）whereas decreased significantly in the control group.Significant differences were found on serum creatinine （t=2.104, P=0.038）and glomerular filtration rate （t=2.120,P=0.037）between the treatment group and the control group at 6 months.No significant changes were observed in 24 hours urine protein and serum hypersensitive C reactive protein levels in both groups. Conclusion Allopurinol therapy can control hyperuricemia in patients with mild-moderate chronic kidney disease and may help improve renal function.