非布司他对比别嘌呤醇治疗慢性肾脏病合并高尿酸血症患者对肾功能及尿酸水平的影响探讨

The Effect of Febuxostat Versus Allopurinol on Renal Function and Uric Acid Level in Patients with Chronic Kidney Disease and Hyperuricemia

目的分析非布司他(Feb)对比别嘌呤醇(All)治疗慢性肾脏病(CKD)合并高尿酸血症(HUA)患者对肾功能及尿酸水平的影响。方法该研究主体为2018年1月—2019年12月间来院治疗的102例CKD合并HUA患者。以抽签法为基准,A组52例行Feb治疗,B组50例行All治疗。对比肾功能指标与尿酸水平。结果A组基线期与治疗6个月的肌酐(SCr)改变值为(-0.06±0.13)mg/dl,B组为(-0.04±0.14)mg/dl,差异有统计学意义(t=0.748,P=0.456);A组基线期与治疗6个月的肾小球滤过率(eGFR)改变值为(0.80±0.24)mL/min,B组为(0.72±0.28)mL/min,差异有统计学意义(t=1.551,P=0.124);A组基线期与治疗6个月的24 h尿蛋白定量改变值为(-0.30±0.24)g,B组为(-0.25±0.17)g,差异有统计学意义(t=1.210,P=0.229)。A组基线期与治疗6个月的SUA改变值为(-3.08±0.25)mg/dl,B组为(-2.27±0.20)mg/dl,差异有统计学意义(t=18.025,P<0.001)。结论Feb对于CKD合并HUA患者的肾功能保护效果较佳,且能显著降低体内的尿酸水平,整体疗效优于All。

Objective To analyze the effects of febuxostat(Feb)versus allopurinol(All)in the treatment of chronic kidney disease(CKD)with hyperuricemia(HUA)on renal function and uric acid levels.Methods The main body of the study was 102 patients with CKD and HUA who came to the hospital for treatment from January 2018 to December 2019.Based on the lottery method,52 cases in group A were treated with Feb,and 50 cases in group B were treated with All.Compare renal function indexes with uric acid levels.Results The change in creatinine(SCr)between the baseline and 6 months of treatment in group A was(-0.06±0.13)mg/dl,and in group B was(-0.04±0.14)mg/dl,the difference was statistically significant(t=0.748,P=0.456);The glomerular filtration rate(eGFR)between the baseline and 6 months of treatment in group A was changed to(0.80±0.24)mL/min,and in group B was(0.72±0.28)mL/min,the difference was statistically significant(t=1.551,P=0.124);the 24 h proteinuria ration change between the baseline period and 6 months of treatment in group A was(-0.30±0.24)g,group B was(-0.25±0.17)g,the difference was statistically significant(t=1.210,P=0.229).The change in SUA between the baseline and 6 months of treatment in group A was(-3.08±0.25)mg/dl,and in group B was(-2.27±0.20)mg/dl,the difference was statistically significant(t=18.025,P<0.001).Conclusion Feb has a better protective effect on renal function in patients with CKD combined with HUA,and can significantly reduce the level of uric acid in the body,and the overall effect is better than that of All.