非布司他联合枸橼酸钾缓释片治疗痛风性肾结石患者的疗效及复发情况分析

Analysis of the efficacy and recurrence of febuxostat combined with potassium citrate extended-release tablets in the treatment of patients with gouty nephrolithiasis

目的探讨非布司他联合枸橼酸钾缓释片治疗痛风性肾结石患者的疗效及复发情况。方法选取2018年12月至2019年12月在本院住院治疗的痛风性肾结石患者120例,采用信封法分为单纯组和联合组,每组60例。单纯组患者给予非布司他治疗,联合组患者给予非布司他联合枸橼酸钾缓释片治疗,疗程14 d。比较两组患者的临床治疗效果、血清可溶性细胞间黏附分子1(sICAM-1)和血尿酸水平;随访6个月,比较两组患者的复发率。结果治疗14 d,单纯组患者的治疗总有效率(70.0%)显著低于联合组(86.7%),差异有统计学意义(P<0.05)。治疗前,两组患者的血尿酸和血sICAM-1水平比较,差异无统计学意义(P>0.05);治疗14 d后,两组患者的血尿酸、sICAM-1水平均显著降低,联合组患者的水平显著低于单纯组(P<0.05)。随访6个月,单纯组患者复发8例、联合组患者复发3例,两组患者的复发率比较差异无统计学意义(P>0.05)。结论非布司他联合枸橼酸钾缓释片治疗痛风性肾结石患者临床疗效显著,能显著降低患者的血尿酸和炎症反应水平,降低患者复发率,值得推广应用。

Objective To explore the efficacy and recurrence of febuxostat combined with potassium citrate extended-release tablets in the treatment of gouty nephrolithiasis.Methods A total of 120 patients with gouty nephrolithiasis hospitalized in our hospital from December 2018 to December 2019 were selected,and they were divided into simple group and combined group by the envelope method,with 60 cases in each group.Patients in the simple group were treated with febuxostat,whereas patients in the combined group were treated with febuxostat combined with potassium citrate extended-release tablets,for a treatment course of 14 days.The clinical therapeutic effects,serum soluble intercellular adhesion molecule 1(sICAM-1)and blood uric acid levels were compared between the two groups.For a six-month follow-up,the recurrence rates of the two groups were compared.Results After 14 days of treatment,the total effective rate(70.0%)of the simple group was significantly lower than that of the combined group(86.7%),and the difference was statistically significant(P<0.05).Before treatment,there were no statistically significant differences in serum uric acid and blood sICAM-1 levels between the two groups(P>0.05).After 14 days of treatment,the blood uric acid and sICAM-1 levels of the two groups significantly decrease,and the levels of the combined group were significantly lower than those of the simple group(P<0.05).After 6 months of follow-up,8 patients in the simple group and 3 patients in the combined group relapsed,but there was no statistically significant difference in the recurrence rate between the two groups(P>0.05).Conclusion Febuxostat combined with potassium citrate extended-release tablets has a prominent clinical efficacy in the treatment of patients with gouty nephrolithiasis,which can significantly decrease the level of blood uric acid and inflammatory response level in patients,and decrease the recurrence rate of patients,and thus it is worthy of promotion and application.