非布司他治疗慢性肾病伴高尿酸血症患者的临床观察

Clinical observation of febuxostat in the treatment of chronic kidney disease with hyperuricemia

目的：探讨非布司他对合并高尿酸血症慢性肾病患者的治疗价值。方法选取120例行慢性肾病（ CKD1－3期）合并高尿酸血症治疗的患者，随机分为非布司他组、别嘌醇组和安慰剂组，每组40例，观察治疗前后各组肌酐、甘油三酯、收缩压、舒张压、尿酸、C－反应蛋白的变化，同时分析尿酸与其他指标的相关性。结果非布司他组和别嘌醇组患者治疗前后组内血尿酸、肌酐、C－反应蛋白比较差异有统计学意义（ P均＜0．05）；非布司他组治疗24周后尿酸、肌酐、C－反应蛋白降低幅度高于别嘌醇组、安慰剂组（P＜0．05），3组患者治疗前后甘油三脂、收缩压、舒张压无明显变化（P＞0．05）；尿酸与肌酐、C－反应蛋白呈正相关（P＜0．05）。结论高尿酸血症需干预治疗，非布司他对合并高尿酸血症的慢性肾病患者有较高的治疗价值。

Objective To evaluate the application of febuxostat in the treatment of chronic kidney disease in pa-tients with hyperuricemia.Methods A total of 120 chronic kidney disease patients （phases 1-3） with hyperuricemia in our hospital were enrolled in the current study.They were divided into a febuxostat group, an allopurinol group and a placebo group.Their changes in creatinine, triglycerides, systolic blood pressure （ SBP ） , diastolic blood pressure （ DBP） , uric acid and C-reactive protein were observed before and after treatment.Meanwhile, the correlation between uric acid and other indexes were analyzed.Results After treatment, the febuxostat group and the allopurinol group pro-duced the levels of uric acid, creatinine and C-reactive protein which were remarkably different from those before treat-ment （P〈0.05）.After 24 weeks of treatment, the amounts of uric acid, creatinine, and C-reactive protein were markedly higher in the febuxostat group than those in the allopurinol group and the placebo group （P〈0.05）.No statis-tically significant differences were found in triglyceride, SBP and DBP in the three groups before and after treatment （ P〉0.05）.The level of uric acid was positively correlated with those of creatinine, and C-reactive protein （P〈0.05）. Conclusion Intervention treatment is necessary for hyperuricemia patients and febuxostat can be used to treat chronic kidney disease patients with hyperuricemia well.