非布司他治疗慢性肾衰竭非透析患者高尿酸血症的疗效观察

Clinical observation of febuxostat in treatment of hyperuricemia in patients with chronic renal failure and non dialysis

目的观察非布司他片治疗慢性肾衰竭非透析患者高尿酸血症的临床疗效。方法选择2014年1月—2015年6月在潍坊市中医院肾内科的60例并发高尿酸血症的慢性肾功能衰竭的住院患者,随机分成对照组和治疗组,每组各30例。所有患者均给予低盐、低蛋白、低嘌呤饮食,并给予慢性肾功能不全的常规治疗。对照组口服别嘌醇片100 mg,3次/d;治疗组口服非布司他片40 mg,1次/d。两组均连续治疗12周。观察两组的临床疗效,并在治疗前及治疗后第1、2、4、6、8、10、12周检查生化指标血尿酸(SUA)、血肌酐(Scr)、血尿素氮(BUN)、丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、血浆白蛋白(ALB)、胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)及血常规相关指标白细胞(WBC)计数、血红蛋白(HB)。结果治疗后,对照组总有效率为80.00%,治疗组总有效率为96.67%,两组总有效率比较差异具有统计学意义(P<0.05)。治疗后,两组患者SUA、Scr、BUN水平均显著降低,同组治疗前后差异具有统计学意义(P<0.05);且治疗组这些观察指标的下降程度优于对照组,两组比较差异具有统计学意义(P<0.05)。两组患者治疗前后ALT、AST、ALB、TG、TC、HDL-C、LDL-C、WBC、HB均无明显改变,差异无统计学意义。结论非布司他片较别嘌醇片更能有效地降低慢性肾功能衰竭非透析患者的SUA水平,起效快,效果肯定,且无明显不良反应,具有一定的临床推广应用价值。

Objective To observe the effect of Febuxostat Tablets in treatment of hyperuricemia in patients with chronic renal failure and non dialysis. Methods Patients（60 cases） with chronic renal failure and non dialysis in Department of Urology of Weifang Traditional Chinese Hospital from January 2014 to June 2015 were randomly divided into control and treatment groups, and each group had 30 cases. All patients were given low salt, low protein, and low purine diet, and given the conventional treatment of chronic renal insufficiency. The patients in the control group were po administered with Allopurinol Tablets, 100 mg/time, three times daily. The patients in the treatment group were po administered with Febuxostat Tablets, 40 mg/time, once daily. The patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated. Biochemical indexes, such as serum uric acid（SUA）, serum creatinine（Scr）, blood urea nitrogen（BUN）, alanine aminotransferase（ALT）, aspartic acid amino shift enzyme（AST）, albumin（ALB）, total cholesterol（TC）, triglyceride（TG）, high density lipoprotein（HDL-C）, and low density lipoprotein cholesterol（LDL-C）, and routine blood test biochemical indicators, such as white blood cell（WBC） count and hemoglobin（HB） were determined before treatment and 1, 2, 4, 6, 8, 10, and 12 weeks after treatment. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 96.67%, respectively, and there were differences between two groups（P〈0.05）. After treatment, the levels of SUA, Scr, and BUN in two groups were significantly decreased, and the difference was statistically significant in the same group（P〈0.05）. And these indicators in the treatment group were lower than those in the control group, with significant difference between two groups（P〈0.05）. After treatment, the levels of ALT, AST, ALB, TG, TC, HDL-C, LDL-C, WBC, and HB had no differences in the same group. Conclusion Compared with Allopurinol Tablets, Febuxostat Tablets has better clinical effect in treatment of hyperuricemia in patients with chronic renal failure and non dialysis, which can effectively reduce the levels of SUA, has rapid effect and define effect with little adverse reaction, and which has a certain clinical application value.