不同剂量非布司他对高尿酸血症伴痛风患者内皮素－1水平的影响

Impact of different dose of Febuxostat on endothelin-1 level in patients with hyperuricemia complicated by gout

目的观察不同剂量非布司他与别嘌呤醇对高尿酸血症伴痛风患者内皮素-1（ET-1）水平的影响及治疗效果。方法选取2014年1月至6月于本院就诊的高尿酸血症伴痛风（缓解期）患者48例，随机分为三组，分别给予别嘌呤醇300mg／d（G1），非布司他40mg／d（G2）及非布司他80mg／d（G3），每组16例。所有患者均连续用药24周，治疗前及治疗后12周、24周时测定血清尿酸及ET-1水平。结果所有患者治疗12周及24周后血清尿酸和ET-1水平较治疗前均显著降低（P〈0．05）；但组间比较，患者治疗12周及24周时血清尿酸和ET-1水平间无统计学差异（P〉0．05）。相关分析显示，血ET-1水平与尿酸水平呈正相关（r=0．461，P=0．000）。结论非布司他40mg或80mg和别嘌醇均可显著降低高尿酸血症伴痛风患者血清尿酸及ET-1水平，改善血管内皮功能。较大剂量非布司他降低ET-1水平的作用尚需进一步观察。

Objective To explore the impact of different doses of Febuxostat and allopurinol on endothelin-1 （ET-1） level in patients with hyperuricemia complicated by gout. Methods From January to June 2014, 48 patients with hyperuricemia and gout （remission stage） treated in our hospital were randomly divided into three groups, and each group was given allopurinol 300 mg/d （G1）, Febuxostat 40 mg/d （G2） or Febuxostat 80 mg/d （G3） for 24 weeks. The levels of uric acid and ET-1 were determined before treatment, after 12, 24 weeks＇ treatment. Results The levels of ET-1 and uric acid both declined significantly in 3 groups after 12, 24 weeks＇ treatment compared with before treatment （P〈0.05）; but there were no statistically significant differences in the levels of ET-1 or uric acid among three groups after 12, 24 weeks＇ treatment （P〉0.05）. The correlation analysis showed that serum ET-1 was positively correlated with uric acid （r=0.461, P=0.000）. Conclusions 40 mg, 80 mg Febuxostat and allopurinol could reduce the levels of ET-1 and uric acid and improve vascular endothelial function in patients with hyperuricemia complicated by gout. Futher observation is still needed to clarify the mechanism of large-dose Febuxostat in reducing ET-1 level.