非布司他治疗老年人无痛风高尿酸血症的疗效  

Clinical curative effect of Febuxostat in the treatment of hyperuricemia in senile patients without gout

作　　者：范名月[1] 

机构地区：[1]武警后勤学院附属医院药剂科,天津300162

出　　处：《中华老年医学杂志》2017年第6期669-672,共4页Chinese Journal of Geriatrics

摘　　要：目的观察非布司他治疗老年人高尿酸血症的效果和安全性。方法112例老年男性高尿酸血症患者随机分为非布司他40mg组（37例）、非布司他80mg组（38例）和别嘌醇组（37例）3组，分别在观察前以及观察2、4、8、12、16、20、24周时抽取患者清晨空腹静脉血样3ml进行分析，检测血尿酸水平和血生化指标（三酰甘油、低密度脂蛋白胆固醇、尿素、肌酐、半胱氨酸蛋白酶抑制剂C等）的变化，观察患者用药期间的不良反应，以及24周后血尿酸达标率。结果别嘌醇组治疗2周后血尿酸值为（500．23±54．72）μmol／L，而非布司他组则分别为（380．07±48．18）μmol／L、（373．53±43．42）μmol／L，差异有统计学意义（F=77．740，P=0．000）；用药4周后非布司他组血尿酸水平已基本达标，别嘌醇组尿酸水平虽有降低，但仍未达到356．88μmol／L以下，非布司他80mg组血尿酸水平降低幅度最大，为（294．43±40．45）μmol／L，非布司他40mg组次之，为（312．86±38．66）μmol／L，别嘌醇组最小，为（464．54±51．75）μmol／L（F=165．330，P=0．000）；用药8周后，3组患者血尿酸水平均基本达标。与治疗前比较，治疗结束后非布司他40mg组和80mg组患者血低密度脂蛋白胆固醇水平均明显降低（P=0．027、0．039），血半胱氨酸蛋白酶抑制剂C（均P=0．004）和血肌酐水平（P=0．037、0．000）有一定程度的降低，未观察到严重的药物不良反应。结论与别嘌醇比较，老年高尿酸血症患者应用非布司他血尿酸水平下降更快，治疗结束时血尿酸达标率更高，且无严重的不良反应，同时可能具有调节血脂水平及潜在的肾保护作用。Objective To observe the efficacy and safety of Febuxostat on elderly patients with hyperuricemia. Methods 112 elderly male patients with hyperuricemia, aged over 65 years with mean age of（72.6±5.8）years. All patients were randomly divided into Febuxostat 40 mg（37 cases）, Febuxostat 80mg（38 cases）and Allopurinol（37 cases）groups. Blood samples were taken before and 2, 4,8, 12, 16, 20, and 24 weeks after treatment. And fasting venous blood samples were taken for detections. The changes of blood uric acid level, blood biochemical indexes （triglyceride, low density lipoprotein cholesterol,urea, creatinine, Cystatin C, etc. ）and side effects during treatment, and the blood uric acid targeting rate after 24 weeks of treatment were observed. Results After 2 weeks of treatment, the blood uric acid level was （500.23 ±54.72）μmol/L in Allopurinol group and（380.07 ±48.18） and （373.53±43.42）μmol/L in two Febuxostat groups, with the statistically significant difference（F= 77. 740, P=0. 000）. After 4 weeks, the level of serum uric acid was basically targeted in Febuxostat group,although Allopurinol group showed uric acid level was reduced, but was not less than the 356.88μmol/L. After 4 weeks of treatment, serum uric acid level was（294.43 ±40.45）μmol/ L in 80mg febuxostat group,（312.86±38.66）μmol/L in Febuxostat 40 mg group, （464.54±51.75）μmol/L in allopurinol group（F=165.330,P= 0. 000）. After 8 weeks of treatment, the blood uric acid level was basically targeted in all three groups. Compared with pre-treatment, after the treatment, the serum levels of low density lipoprotein cholesterol, Cystatin C and creatinine in the groups of 40 mg and 80 mg Febuxostat showed a certain degree of reduction（P = 0. 027,0. 039 ; both P = 0. 004, P = 0. 037,0. 000 respectively）. And no serious adverse reactions were found. Conclusions Compared with Allopurinol treatment,Febuxostat tretment shows that the blood uric acid level drops faster, the target-reaching rate is higher at

关 键 词：高尿酸血症 黄嘌呤氧化酶 

分 类 号：R589.7[医药卫生—内分泌]