短期口服中等剂量的醋酸泼尼松片对合并有慢性肾病1～3期的急性痛风性关节炎的疗效与安全性

Efficacy and safety of Short--term moderate dose oral prednisolon in the treatment of acute gout arthritis complicating chronic kidney disease(stage 1～3)

目的探讨短期口服中等剂量的醋酸泼尼松片(强的松)对伴慢性肾病(CKD)1~3期时的急性痛风性关节炎的疗效与安全性。方法使用口服中等剂量的醋酸泼尼松片(强的松)对68例伴有CKD 1~3期的急性痛风性关节炎患者进行了7 d的治疗,详细记录疗效及发生的不良反应。结果患者进行评估的受累关节疼痛程度在服药治疗的第1天就有显著减轻(P <0.05),在治疗第7天时关节疼痛接近完全缓解(P=0.013)。研究者评估的受累关节疼痛程度在服药治疗的第2天就有显著减轻(P <0.05),在服药第7天时,接近完全缓解(P=0.024)。研究者评估的受累关节的皮肤发红程度、关节压痛程度及关节肿胀程度在在服药7 d后均有显著减轻(P <0.05)。痛风患者及研究者对治疗的整体疗效评估结果均提示口服中等剂量的泼尼松片对急性痛风性关节炎的有效率高达100%,超过63%的患者在治疗后完全缓解。仅有3例(4.23%)痛风患者在服药过程中出现恶心,有4例(5.63%)痛风患者在服药过程中出现轻微腹痛,上述症状均可迅速缓解。痛风患者肾功能在治疗结束后有无显著变化,血肌酐水平仍有轻、中度增高。结论短期口服中等剂量的醋酸泼尼松片(强的松)对伴CKD 1~3期时的急性痛风性关节炎疗效迅速、肯定,安全性较好,不会加重痛风患者已有的肾功能损害。

Objective To evaluate the efficacy and safety of Short--term moderate dose oral prednisolon in the treatment of acute gout arthritis complicating chronic kidney disease(stage 1～3)(CKD).Methods A total of 68 patients with acute gout arthritis complicating CKD(stage 1～3)were treated for 7 days with oral prednisolon 30 mg per day.The primary efficacy end point was the patient--s assessment of pain in the involed joint(0～4 point Likert scale)over days 1～7.Safety was assessed by adverse experiences occurring during the treatment.Results Oral prednisolon were effective in improving pain,tenderness,erythema,patient--s and investigator--s global assess-ments of response to therapy(P<0.05),and had a very low incidence of drug-related aside effects.Conclu-sion Our study suggested that oral prednisolone was an effective treatment for acute gout arthritis complicating CKD(stage 1～3),and it was generally safe and well tolerated.