IgA肾病合并高尿酸血症患者的治疗及预后观察  

Treatment and prognosis of IgA nephropathy patients with hyperuricemia

作　　者：刘方[1] 张慧[1] 蒋易容[2] 

机构地区：[1]武警河南总队医院医务处,河南郑州450052 [2]四川大学华西医院肾脏内科,四川成都610041

出　　处：《海南医学院学报》2014年第1期77-79,共3页Journal of Hainan Medical University

基　　金：四川省青年科技基金(2011JTD0014)~~

摘　　要：目的:观察碳酸氢钠和别嘌呤醇结合泼尼松治疗IgA肾病合并高尿酸血症患者的临床效果及预后。方法:选取我科收治的60例IgA肾病合并高尿酸血症患者,分为两组,对照组予以泼尼松治疗,观察组在泼尼松治疗基础上加用碳酸氢钠1.5g/d和别嘌呤醇0.1g,对比两组患者治疗8周前后的血肌酐(Scr)、血尿酸(UA)、24h尿蛋白定量、肾小球滤过率(GFR)、总胆固醇(TC)和低密度脂蛋白(LDL)。结果:组内比较:两组患者治疗8周后血尿酸、总胆固醇和低密度脂蛋白水平均显著低于治疗前,而GFR高于治疗前,差异具有统计学意义(P均<0.05);组间比较:观察组治疗8周后Scr、UA、24h尿蛋白定量、TC和LDL低于对照组,GFR高于对照组,差异具有统计学意义(P均<0.01)。结论:碳酸氢钠和别嘌呤醇结合泼尼松治疗IgA肾病合并高尿酸血症患者,能显著降低患者的血肌酐和血尿酸,改善蛋白尿情况和肾小球滤过率,同时降低患者血脂水平,从而改善患者预后和生活质量。Objective：To observe the effect of allopurinol sodium bicarbonate＋prednisone on patients with IgA nephropathy and hyperuricemia.Methods：A total of 60patients with IgA nephropathy and hyperuricemia from May 2011to May 2013were selected,and were divided into two groups：the control group receiving prednisone,and observation group receiving prednisolone,sodium bicarbonate 1.5g/d and allopurinol 0.1g/d.Serum creatinine（Scr）,serum uric acid（UA）,24hurinary protein excretion,glomerular filtration rate（GFR）,total cholesterol（TC）and low density lipoprotein（LDL）were observed and compared between two groups and before and after 8weeks of treatment.Results：After 8weeks of treatment,UA,TC and LDL were significantly decreased;GFR was significantly increased（P0.05）in both two groups.After 8weeks of treatment,Scr,UA,TC,24hurinary protein and LDL in experimental group were significantly lower than those of control group（P0.01）;GFR in the experimental group was significantly higher than that of control group（P0.01）.Conclusion：Sodium bicarbonate＋ allopurinol combined with prednisone can significantly decrease Scr and UA in patients with IgA nephropathy and hyperuricemia,improve the situation of proteinuria and glomerular filtration rate,reduce blood lipid levels,to improve prognosis and quality of life of patients.

关 键 词：IGA肾病 高尿酸血症 碳酸氢钠 别嘌呤醇 

分 类 号：R589[医药卫生—内分泌]