双能CT检测对非布司他治疗尿酸盐结晶痛风患者的疗效评估  

Follow up the treatment of gout tophi by DECT

作　　者：吴春叶[1] 龚宝琪[2] 屈瑾[2] WU Chunye;GONG Baoqi;QU Jjin(Department of Immunity,The 254th Hospital of PLA,Tianjin 300142,China;Department of Immunity,The Tianjin First Hospital,Tianjin 300192,China)

机构地区：[1]中国人民解放军第254医院免疫科,天津300142 [2]天津市第一中心医院风湿免疫科,天津300192

出　　处：《西部医学》2018年第9期1344-1347,1352,共5页Medical Journal of West China

基　　金：天津市卫计委科技基金(2015KZ024)

摘　　要：目的探讨分别给予非布司他和别嘌醇缓释胶囊治疗尿酸盐结晶痛风患者的临床疗效及双能CT的疗效评估。方法以天津第一中心医院风湿免疫科2015年6月~2016年5月就诊的100例痛风患者为研究对象,随机分为两组,其中A组50例,给予非布司他20mg^40mg.1次/日口服;B组50例,给予别嘌醇缓释胶囊250mg.1次/日口服。分别记录治疗前后尿酸结晶数、平均尿酸晶体体积、血清C反应蛋白(CRP)及血尿酸值变化;通过双能CT(dual energy CT,DECT)对尿酸盐结晶溶解的疗效进行评估。结果 A组治疗前后尿酸盐结晶数、平均尿酸盐晶体体积、血清CRP及血尿酸值改变具有统计学意义(P<0.05)。B组治疗前后血清CRP及血尿酸值改变具有统计学意义(P<0.05),尿酸盐结晶数、平均尿酸盐晶体体积改变无统计学学意义(P>0.05)。降尿酸治疗1年后,A、B组在血清CRP及血尿酸值改变无统计意义(P>0.05),在痛风石数目、尿酸盐结晶数、平均尿酸盐晶体体积改变具有统计意义(P<0.05)。结论对有尿酸盐结晶痛风患者给予非布司他治疗,可在尿酸持续达标的基础上,持续溶解尿酸盐结晶,疗效明确,优于别嘌醇缓释胶囊,具有很好的临床运用前景;双能CT检测对有尿酸盐结晶的痛风患者的治疗起到监测疗效和评估作用。Objective To investigate the efficacy and follow-up of 12 months after the Febuxostat and allopurinol treatment of gouty tophi by DECT.Methods 100 gout patients were divided into A group implemented on the febuxostat treatment and B group implemented on the allopurinol treatment.The amount of urate crystal number,the average urate crystal volume,CRP and uric acid level were observed.Results There were statistical differences between the amount of urate crystal number,the average urate crystal volume,CRP,and uric acid level before and after febuxostat treatment.There were statistical differences between CRP,uric acid level before and after allopurinol treatment.Conclusion We can use DECT to monitor and evaluate the curative effect of gouty tophi.The gouty tophi of patients treated with Febuxostat for 12 months,could be dissolved on the basic of continuous uric acid standard,which indicates that Febuxostat was effective in the treatment of tophi and had clinical application prospects.

关 键 词：非布司他 双能CT 尿酸盐结晶 疗效 别嘌醇缓释胶囊 

分 类 号：R589.8[医药卫生—内分泌]