非布司他与别嘌呤醇治疗原发性痛风的疗效及其对胰岛素抵抗的影响研究  

Efficacy of Febuxostat versus Allopurinol in the Treatment of Primary Gout and Their Effects on Insulin Resistance

作　　者：孟娟[1] 袁晓旭[1] 路跃武[1] MENG Juan YUAN Xiao - xu LU Yue - wu(Department of Rheumatology and Immunology, Beijing Chao - Yang Hospital, Capital Medical University, Belling 100020, China)

机构地区：[1]首都医科大学附属北京朝阳医院风湿免疫科,北京市100020

出　　处：《中国全科医学》2017年第30期3745-3748,共4页Chinese General Practice

摘　　要：目的比较非布司他与别嘌呤醇治疗原发性痛风的疗效及其对胰岛素抵抗(IR)的影响。方法选取2013年11月—2015年5月首都医科大学附属北京朝阳医院门诊收治的符合纳入标准的原发性痛风患者52例为研究对象。使用SPSS 19.0软件将患者按1∶1的比例随机分为非布司他组(给予非布司他片)及别嘌呤醇组(给予别嘌呤醇片)。收集患者一般资料,分别检测患者治疗前和治疗24周末血清尿酸(UA)、天冬氨酸氨基转移酶(AST)、丙氨酸氨基转移酶(ALT)、肌酐(Cr)、空腹血糖(FBG)、空腹胰岛素(INS)水平,计算稳态模型评估胰岛素抵抗指数(HOMA-IR)。结果治疗前两组UA、AST、ALT、Cr、FBG、INS水平和HOMA-IR比较,差异无统计学意义(P>0.05);治疗后非布司他组UA、INS水平低于别嘌呤醇组(P<0.05);治疗后两组AST、ALT、Cr、FBG水平和HOMA-IR比较,差异无统计学意义(P>0.05)。别嘌呤醇组治疗后UA水平低于治疗前(P<0.05);非布司他组治疗后UA、INS水平和HOMA-IR低于治疗前(P<0.05)。结论非布司他比别嘌呤醇能更有效地控制原发性痛风患者血清UA水平,并能改善IR情况。Objective To investigate the efficacy of febuxostat versus allopurinol in the treatment of primary gout and their effects on insulin resistance. Methods We enrolled 52 primary gout patients who received outpatient treatment in Beijing Chao - Yang Hospital, Capital Medical University from November 2013 to May 2015 and met the inclusion criteria of this study. Using SPSS 19. 0 software, they were randomized into febuxostat group receiving oral administration of febuxostat tablets and allopurinol group receiving oral administration of allopurinol tablets at a ratio of 1 ： 1. The baseline data of both groups were collected： The levels of serum uric acid （UA）, aspartate aminotransferase （AST）, alanine aminotransferase （ALT）, creatinine （Cr）, fasting blood glucose （FBG） and fasting insulin （INS） were detected, the homeostasis model assessment of insulin resistance （HOMA - IR） was calculated before treatment and at 24 weeks after treatment. Results The levels of UA, AST, ALT, Cr, FBG and INS and HOMA - IR did not differ significantly between the two groups before treatment （ P 〉 0.05 ）. After treatment, the levels of UA and INS in febuxostat group were lower than those in allopurinol group （P 〈 0. 05 ）, but the levels of AST, ALT, Cr and FBG and HOMA - IR were still similar in both groups （ P 〉 0. 05 ） . The level of UA after treatment was significantly lower than that before treatment in allopurinol group （ P 〈 0. 05 ） . The levels of UA and INS and HOMA - IR after treatment were significantly lower than those before treatment in febuxostat group （P 〈 0. 05 ） . Conclusion Compared with allopurinol, febuxostat can better control the serum UA level of patients with primary gout, and it can improve the level of IR.

关 键 词：痛风 疗效比较研究 别嘌呤醇 胰岛素抵抗 非布司他 

分 类 号：R589.7[医药卫生—内分泌]