不同剂量非布司他治疗慢性肾脏病伴高尿酸血症的临床研究

Treatment of chronic renal disease with hyperuricemia by different doses of febuxostat

目的研究不同剂量非布司他治疗慢性肾病(CKD)伴高尿酸血症的临床应用价值。方法纳入90例CKD伴HUA患者作为研究对象,随机分为三组,每组各30例。三组均接受基础治疗。A组给予别嘌醇300 mg/d,B组给予非布司他40 mg/d,C组给予非布司他80 mg/d。疗程6个月。采用卡方检验比较三组治疗效果和不良反应发生情况,采用配对t检验比较治疗前后血尿酸(SUA)水平。结果三组治疗效果差异有统计学意义(χ~2=7.917,P=0.019),B、C组疗效显著优于A组(χ~2=4.356,5.963;P=0.037,0.015),B、C两组间疗效差异无统计学意义(χ~2=0.000,P=1.000)。治疗后B、C两组SUA显著低于A组(t=4.018,t=5.437;P<0.05),但B、C两组组间比较差异无统计学意义;B组不良反应发生率低于A、C两组,但差异无统计学意义。结论非布司他治疗CKD伴高尿酸血症效果优于别嘌醇,小剂量非布司他与大剂量相比,具有较高的安全性且疗效相仿。

Objective To study the clinical value of different doses febuxostat in treating chronic kidney disease（ CKD） patients with hyperuricemia（ HUA）. Methods 90 CKD patients with HUA were enrolled and randomly divided into three groups with 30 patients each. All the three groups received basic treatment. And group A were treated with allopurinol 300 mg/d,group B treated with febuxostat 40 mg/d,while group C treated with febuxostat 80 mg/d. The course of treatment was 6 months. The therapeutic effects and adverse reactions among the three groups were compared with Chi-square test,and the renal function and serum uric acid（ SUA） level before and after treatment were compared with paired t test.Results There were significant differences in therapeutic effects among the three groups（ χ^2= 7. 917,P =0. 019）,and the therapeutic effects of groups B and C were better than that of group A（ χ^2= 4. 356,5. 963;P = 0. 037,0. 015,respectively）. After treatment,the levels of SUA in group B and group C were both significantly lower than that in group A（ t = 4. 018,t = 5. 437; P〈0. 05）,and the incidence of adverse reactions in group B was lower than in group A or group C without statistical significance. Conclusions The therapeutic effect of febuxostat for CKD with hyperuricemia was better than that of allopurinol. Small doses of febuxostat was with higher level of safety than the larger doses.