小剂量降尿酸药物治疗肾移植后高尿酸血症的疗效及安全性分析

Efficacy and Safety of Low Dose Uric Acid Lowering Drugs in the Treatment of Hyperuricemia after Renal Transplantation

目的:探讨小剂量降尿酸药物治疗肾移植后高尿酸血症的疗效及安全性。方法:选择2017年5月至2019年5月于门诊随诊的肾移植后高尿酸血症患者80例进行研究,以随机数表法分为A组(n=28)、B组(n=26)和C组(n=26)。A组给予非布司他(20 mg qd)治疗,B组给予苯溴马隆(25 mg qd)治疗,C组给予别嘌(100 mg qd)治疗。比较两组患者的临床疗效、血尿酸(s UA)、尿素氮(BUN)、血肌酐(sCr)、估算肾小球滤过率(eGFR)水平变化情况及不良反应发生情况。结果:治疗4周后,三组总有效率分别为89.29%、88.46%、84.62%,比较差异无显著性意义(P>0.05);治疗前,三组血尿酸水平无显著差异;治疗后,三组血尿酸水平均有所改善,但治疗后三组间血尿酸水平差异无显著性意义;治疗前,三组肾功能水平无显著差异;治疗后肾功能变化无显著性意义;治疗后,A组不良反应总发生率为7.14%,显著低于B组的30.77%,C组的34.62%,差异有显著性意义(P<0.05)。结论:在肾移植后高尿酸血症患者中应用小剂量非布司他、苯溴马隆、别嘌醇三种不同的降尿酸药物均能有效果降低血尿酸,但未观察到改善肾功能,非布司他显示出更少的副作用。

Objective: To study efficacy and safety of low dose uric acid lowering drugs in the treatment of hyperuricemia after renal transplantation. Methods: 80 patients with hyperuricemia after kidney transplantation who were followed up in outpatient clinics from May 2017 to May 2019 were enrolled for the study, and were divided into group A(n=28), group B(n=26) and group C(n=26) by random number table. Group A was treated with febuxostat(20 mg qd), group B with benzobromalone(25 mg qd), and group C with allopurinol(100 mg qd). The clinical efficacy, serum uric acid(s UA), urea nitrogen(BUN), serum creatinine(sCr), estimated glomerular filtration rate(eGFR) and the occurrence of adverse reactions of the two groups were compared. Results: After 4 weeks of treatment, the total effective rates of the three groups were 89.29%, 88.46% and 84.62%, respectively, with no significant difference(P>0.05). Before treatment, there was no significant difference in serum uric acid levels among the three groups. After treatment, uric acid levels in the blood of the three groups were improved, but no significant difference in serum uric acid levels among the three groups after treatment.Before treatment, there was no significant difference in renal function among the three groups. There was no significant change in renal function after treatment. After treatment, the overall incidence of adverse reactions in group A was 7.14%, significantly lower than that in group B(30.77%) and group C(34.62%), with significant difference(P<0.05). Conclusion: Febulostat, benzobromalone and allopurinol were all effective in lowering uric acid in patients with hyperuricemia after kidney transplantation, but o improvement in renal function was observed, febuxostat shows fewer side effects.