痛风患者血尿酸与血脂水平的关系及非布司他的降血脂作用

Relationship between serum uric acid and lipid levels in patients with gout and effect of febuxostat on reducing serum lipid levels

目的:探讨痛风患者血尿酸(UA)与血脂水平的关系及非布司他的降血脂作用。方法:选择60例男性痛风患者作为痛风组,25例健康体检的男性作为正常对照组,比较2组研究对象的UA及血脂水平。对痛风组中有高脂血症的42例患者进行降UA治疗,采用双盲试验,根据患者使用药物情况分为低剂量非布司他组(非布司他40mg·d-1,n=13)、高剂量非布司他组(非布司他80mg·d-1,n=16)和别嘌醇治疗组(别嘌醇300mg·d-1,n=13),观察各组研究对象治疗前后血UA及血脂水平。结果:与正常对照组比较,痛风组患者UA、血清甘油三脂(TG)、总胆固醇(TC)、低密度脂蛋白(LDL)水平均升高(P<0.05),且痛风组患者UA与TG水平呈正相关关系(r=0.275,P<0.05);低剂量非布司他组患者治疗后高密度脂蛋白(HDL)水平较治疗前升高(P<0.05),且治疗后HDL水平与正常对照组比较差异无统计学意义(P>0.05);与治疗前比较,高剂量非布司他组患者治疗后TC、LDL和TG水平下降,HDL水平升高(P<0.05),且治疗后TC、HDL、LDL和TG水平与正常对照组比较差异无统计学意义(P>0.05);别嘌醇组患者治疗前后TC、HDL、LDL和TG水平比较差异均无统计学意义(P>0.05)。高、低剂量非布司他组和别嘌醇组患者治疗后UA水平均下降,与治疗前比较差异均有统计学意义(P<0.05);高剂量非布司他组患者治疗后UA水平与正常对照组比较差异无统计学意义(P>0.05)。结论:痛风患者常并发高脂血症,非布司他在降低UA水平的同时可以降低血脂水平,非布司他(80mg·d-1)能降低痛风患者LDL、TC和TG水平,升高HDL水平。

Objective To explore the relationship between serum uric acid（UA）and serum lipid levels in the patients with gout and the effect of febuxostat on reducing the serum lipid levels.Methods 60 male patients with gout were chosen as gout group,and 25 healthy controls were chosen as control group.The serum uric acid and lipid levels of the objects were compared between gout and control groups.42 patients with hyperlipidemia in gout group were chosen and divided into three subgroups,such as low dose of febuxostat group（febuxostat40mg·d^-1,n=13）,high dose of febuxostat group（febuxostat 80 mg·d^-1,n=16）,and allopurinol group（allopurinol 300 mg·d^-1,n=13）.The double blind method was used.The serum UA and lipid levels of the objects in three subgroups and control group before and after treatment were compared.Results The levels of serum UA,triglycerides（TG）,total cholesterol（TC）,low density lipoprotein（LDL）of the patients in gout group were higher than those in control group（P〈0.05）.The level of UA was positively correlated with TG in gout group（r=0.275,P〈0.05）.Compared with before treatment,the level of high density lipoprotein（HDL）after treatment in low dose of febuxostat group was increased（P〈0.05）;compared with control group,the levels of HDL of the patients in low dose of febuxostat group after treatment had no significant difference（P〈0.05）.Compared with before treatment,the levels of TC,HDL,LDL,and TG of patients after treatment in high dose of febuxostat group were increased（P〈0.05）;Compared with control group,the levels of TC,HDL,LDL and TG of the patients in high dose of febuxostat group after treatment had no significant difference（P〈0.05）.There were no significant differences of TC,HDL,LDL,and TG of the patients in allopurinol group between before and after treatment（P〉0.05）.Compared with before treatment,the UA levels were decreased after treatment in low dose of febuxostat group,high dose of febuxostat group and allopurinol group（P〈0.05）;compared with control group,the UA level of the patients in high dose of febuxostat group had no statistically significant difference（P〈0.05）.Conclusion The patients with gout are often combined with hyperlipidemia.Febuxostat may lower the levels of serum UA and lipids,and febuxostat（80mg·d^-1）may reduce the levels of LDL,TC,TG,and increase the level of HDL.