别嘌醇治疗对CKD合并高尿酸血症UA、eGFR及蛋白尿的影响

Effects of allopurinol treatment on UA,eGFR and proteinuria in CKD complicated with hyperuricemia

目的 分析别嘌醇治疗慢性肾脏病(CKD)合并高尿酸血症临床疗效及对尿酸(UA)、肾小球滤过率(e GFR)及蛋白尿的影响。方法 选取2019年3月至2021年4月首都医科大学附属北京世纪坛医院收治的104例CKD合并高尿酸血症的患者作为本次研究对象,将其设为研究组(n=54)和对照组(n=50)。比较两组患者治疗后临床疗效、UA、e GFR及蛋白尿的水平以及炎性因子[C反应蛋白(CRP)、肿瘤坏死因子-α(TNF-α)、白细胞介素-6(IL-6)]水平、不良反应。结果 研究组的总有效率(96.30%)显著高于对照组(84.00%),差异有统计学意义(P<0.05)。治疗12个月后研究组UA水平明显低于对照组,差异有统计学意义(P<0.05);治疗6个月、治疗12个月后研究组eGFR高于对照组,蛋白尿低于对照组,差异均有统计学意义(P<0.05)。研究组患者治疗后的CRP、TNF-α、IL-6水平均低于对照组,差异有统计学意义(P<0.05)。治疗后两组的不良反应情况比较差异无统计学意义(P>0.05)。结论 采用别嘌醇对CKD合并高尿酸血症的患者进行治疗后,UA、eGFR及蛋白尿都得到明显改善,安全性高,临床疗效显著,值得推广应用。

Objective To analyze the clinical efficacy of allopurinol in the treatment of chronic kidney disease(CKD)complicated with hyperuricemia and its effects on uric acid(UA),glomerular filtration rate(eGFR)and proteinuria. Methods A total of 104 patients with CKD and hyperuricemia admitted to Beijing Shijitan Hospital Affiliated to Capital Medical University from March 2019 to April 2021 were selected as the research subjects,and they were set as the research group(n=54)and the control group(n=50). The clinical curative effect,levels of UA,eGFR and proteinuria as well as inflammatory factors[C-reactive protein(CRP),tumor necrosis factor-α(TNF-α),interleukin-6(IL-6)]were compared between the two groups after treatment. Results The total effective rate of the study group(96.30%)was significantly higher than that of the control group(84.00%),and the difference was statistically significant(P<0.05). The UA level of the study group was significantly lower than that of the control group after 12 months of treatment,the difference is statistically significant(P<0.05). The eGFR of the study group was higher than that of the control group after 6months of treatment and 12 months of treatment,and the proteinuria in the study group was lower than that in the control group,and the difference was statistically significant(P<0.05). The levels of CRP,TNF-α and IL-6in the study group after treatment were lower than those in the control group,and the difference was statistically significant(P<0.05). There was no significant difference in adverse reactions between the two groups after treatment(P>0.05). Conclusion After allopurinol is used to treat patients with CKD complicated with hyperuricemia,UA,eGFR and proteinuria are all significantly improved,with high safety and significant clinical efficacy,which is worthy of popularization and application.