非布司他治疗慢性肾脏病合并高尿酸血症的临床研究

Use of febuxostat for treatment of chronic kidney disease with hyperuricemia

目的:研究非布司他治疗慢性肾脏病合并高尿酸血症的临床疗效及安全性。方法:选择2018年4月至2019年11月期间开平市中心医院收治和暨南大学附属第一医院收治的慢性肾脏病(CDK2~4期)合并高尿酸血症的患者作为研究对象,根据随机数表将患者分为实验组(50例)和对照组(61例)。实验组患者采用非布司他联合碳酸氢钠治疗,对照组患者采用别嘌醇联合碳酸氢钠治疗。比较两组患者治疗前后血清尿酸、血清肌酐、尿素氮、C-反应蛋白等生化指标,以及患者临床症状改善程度,综合评价临床疗效,同时比较两组患者治疗后过敏、腹泻、急性痛风性关节炎、肝功能不全等不良反应差异。结果:治疗后,实验组患者的SUA、Scr、BUN、CRP均小于对照组(P<0.05);实验组患者的临床疗效优于对照组(P<0.05);实验组患者出现腹泻及急性痛风性关节炎发作的不良反应发生率小于对照组(P<0.05),而在过敏、肝功能不全、尿量异常的发生率上,两组间差异无统计学意义(P>0.05)。结论:非布司他联合碳酸氢钠治疗慢性肾脏病合并高尿酸血症的临床疗效较优于别嘌醇联合碳酸氢钠治疗,同时降低了腹泻及急性痛风性关节炎发作的不良反应发生率。

Objective:To investigate the clinical efficacy and safety of febuxostat in the treatment of chronic kidney disease with hyperuricemia.Methods:Patients with chronic kidney disease(CDK at stages 2-4)and hyperuricemia treated in Kaiping Central Hospital or First Affiliated Hospital of Jinan University beween April 2018 to November 2019 were enrolled as subjects.According to the random number table,the patients were divided into the study group(n=50)and control group(n=61).Patients in the study group were treated with febuxostat and sodium bicarbonate,while those in the control group were treated with allopurinol and sodium bicarbonate.The blood biochemical indicators such as serum uric acid(SUA),serum creatinine(Scr),blood urea nitrogen(BUN),and C-reactive protein(CRP)levels before and after treatment,as well as the improvement in clinical symptoms,were compared between the two groups of patients.The clinical efficacy in the two groups was comprehensively evaluated.The differences in adverse reactions such as allergy,diarrhea,acute gouty arthritis,and liver insufficiency after the treatment between the two groups were also noted.Results:After treatment,the study group showed lower levels of SUA,Scr,BUN,and CRP(P<0.05),as well as better clinical efficacy(P<0.05),compared with the control group.The study group experienced less onset of diarrhea and acute gouty arthritis compared with the control group(P<0.05),but there was no statistically significant difference between the two groups in the incidence of allergies,liver insufficiency,and abnormal urine output(P>0.05).Conclusion:Febuxostat plus sodium bicarbonate is with better clinical efficacy in the treatment of chronic kidney disease with hyperuricemia compared with allopurinol plus sodium bicarbonate;and meanwhile,with less incidence of adverse reactions such as diarrhea and acute gouty arthritis.