非布司他联合前列地尔治疗慢性肾衰竭的疗效及高尿酸血症对血液流变学的影响

Efficacy and Safety of Febuxostat Combination with Alprostadil in Treatment of Chronic Renal Failure and Influence Onhyperuricemia Andhemorheology

目的:探讨非布司他联合前列地尔治疗慢性肾衰竭的疗效及对高尿酸血(UA)症、血液流变学的影响性.方法:选择2015年2月至2018年2月我院接诊的90例慢性肾衰竭患者作为本研究对象,通过简单随机数表法分为观察组50例,对照组40例,对照组在常规治疗基础上给予非布司他治疗,观察组联合前列地尔治疗,连续治疗4周.比较两组临床疗效、实验室指标、血液流变学的变化及不良反应.结果:治疗后,观察组临床疗效总有效率显著高于对照组[86.00%(43/50)vs67.50%(27/40)](P<0.05);两组尿素氮(BUN)、血肌酐(Scr)、24h尿蛋白、UA、全血高切粘度、全血低切粘度、血浆粘度在组间·不同时间点具有交互作用(P<0.05);观察组在静脉推注前列地尔过程中有2例注射部位发红,两组治疗期间均无恶心呕吐、明显肝功能异常、关节痛等不良反应.结论:在慢性肾衰竭患者中使用非布司他联合前列地尔效果显著,可有效改善血液高凝状态及肾功能,降低UA表达,且不增加药物不良反应,临床应用价值高.

Objective: To study the efficacy and safety of febuxostat combination withalprostadil in treatment of chronic renal failure and influence on hyperuricemia(UA) and hemorheology. Methods: 90 patients of chronic renal failure who received therapy from February 2015 to February 2018 in our hospital were selected as research objects,theywere divided into observation group (50 cases) and control group (40 cases) by simple random number table method,on the basis of routine treatment, the control group was treated with febuxostat, and the observation group was treated with Alprostadil for 8 weeks.The clinical efficacy, laboratory indexes, hemorheological changes and adverse reactions of the two groups were compared. Results:: After treatment, the total effective rate of the observation group was significantly higher than those in the control group(P<0.05);there were significant differences in urea nitrogen (BUN), serum creatinine (Scr), 24-hour urinary protein, UA, whole blood high shear viscosity, whole blood low shear viscosity and plasma viscosity between groups at interblock·different time points(P<0.05);in the observation group, there were 2 cases of redness in the injection site during the intravenous injection of alprostadil, and there were no nausea and vomiting, obvious abnormal liver function, joint pain and other adverse reactions during the treatment of the two groups. Conclusion:: Febuxostat combination withalprostadil is well for chronic renal failure, which can effectively improve blood hypercoagulability and renal function, reducing UA expression, and without increasing adverse drug reactions and has high clinical value.