非布司他联合血液透析对慢性肾脏病的疗效及对成纤维细胞生长因子23及骨代谢的影响

Effects of febuxostat combined with hemodialysis on chronic kidney disease and effect on fibroblast growth factor 23 and bone metabolism

目的探讨非布司他联合血液透析治疗慢性肾脏病(chronic kidney disease,CKD)的效果及对成纤维细胞生长因子(fibroblast growth factor,FGF)23及骨代谢的影响。方法选择2020年2月至2021年2月在我院肾内科接受治疗的CKD患者105例,采用随机数表法分为试验组(n=53,血液透析+非布司他)和对照组(n=52,血液透析)。比较两组临床疗效、血清FGF23、血尿酸、血钙、血磷、甲状旁腺激素(parathyroid hormone,PTH)、血肌酐(serum creatinine,Scr)、血尿素氮(blood urea nitrogen,BUN)水平及不良反应发生情况。结果治疗后,对照组及试验组总有效率差异有统计学意义(51.92%vs 81.13%,P<0.05),不良反应发生率差异无统计学意义(9.43%vs 19.23%,P>0.05)。两组血清FGF23、血尿酸、血磷、PTH、Scr、BUN水平均随时间推移而下降,且试验组低于对照组,差异有统计学意义(P<0.05)。两组血钙水平均随时间推移而升高,且试验组高于对照组,差异有统计学意义(P<0.05)。血清FGF23及血尿酸与血磷、PTH、Scr及BUN呈正相关(P<0.05),与血钙呈负相关(P<0.05)。结论在CKD患者中应用非布司他联合血液透析效果显著,可有效改善血清FGF23及骨代谢水平,且安全性较佳。

Objective To investigate the effect of febuxostat combined with hemodialysis in the treatment of chronic kidney disease(CKD)and its effect on fibroblast growth factor(FGF)23 and bone metabolism.Methods A total of 105 patients with CKD who treated at the department of nephrology in our hospital from February 2020 to February 2021 were selected and divided into experimental group(n=53,hemodialysis+febuxostat)and control group(n=52,hemodialysis)by random number table method.The clinical efficacy,serum FGF23,serum uric acid,serum calcium,blood phosphorus,parathyroid hormone(PTH),serum creatinine(Scr),blood urea nitrogen(BUN)and occurrence of adverse reactions were compared between the two groups.Results After treatment,there was a statistically significant difference in the total effective rate between the control group and the experimental group(51.92%vs 81.13%,P<0.05),but no statistically significant difference in the incidence of adverse reactions(9.43%vs 19.23%,P>0.05).The levels of serum FGF23,blood uric acid,blood phosphorus,PTH,Scr and BUN in both groups were decreased with time,and the experimental group were lower than those in the control group,the differences were statistically significant(P<0.05).The serum calcium level of both groups increased with time,and the experimental group was higher than that in the control group,the difference was statistically significant(P<0.05).Serum FGF23 and blood uric acid were positively correlated with blood phosphorus,PTH,Scr and BUN(P<0.05),and negatively correlated with blood calcium(P<0.05).Conclusion Febuxostat combined with hemodialysis has a significant effect in patients with CKD,which can effectively improve serum FGF23 and bone metabolism,with good safety.