非布司他对慢性肾脏病合并高尿酸血症患者的临床效果及对炎症水平的影响  

Effects of febuxostat on chronic kidney disease with hyperuricemia and its inflammatory level

作　　者：秦林芳 张瑞敏 杨素霞[1] 时军[1] Qin Linfang

机构地区：[1]河南大学淮河医院

出　　处：《中医临床研究》2019年第13期126-129,共4页Clinical Journal Of Chinese Medicine

摘　　要：目的:分析非布司他对慢性肾脏病(Chronic Kidney Diseas,CKD)3期合并高尿酸血症患者的临床效果及对炎症水平的影响。方法:选取2015年3月-2017年9月在我院接受治疗的136例CKD3-4期合并高尿酸血症患者,除常规用药外,根据降尿酸药物使用情况将患者分为治疗组(70例)和对照组(66例),治疗组患者使用非布司他(每日40mg)治疗,对照组使用别嘌醇等降尿酸药物治疗。记录两组患者基线并使用酶联免疫吸附实验(Enzyme-Linked Immunosorbent Assay,ELISA)法检测两组患者血清中性粒细胞趋化蛋白-1(Neutrophil Chemoattractant Protein-1,MCP-1)及血清白介素-6(Interleukin-6,IL-6)水平。主要终点定义为肾小球滤过率(Glomerular Filtration Rate,GFR)与基线相比下降10%以上,治疗6个月后对比两组患者尿酸控制情况及主要终点数,并对比两组患者血清炎症水平的变化。结果:治疗6个月后,两组患者血尿酸水平对比无明显差异,无统计学意义(P>0.05)。与基线相比,治疗组患者GFR水平与基线对比无明显差异,而对照组患者GFR水平明显降低,对比差异具有统计学意义。根据GFR水平分为高GFR组[GFR≥45mL/(min·1.73m^2)]和低GFR组[GFR≤45mL/(min·1.73m^2)],在低GFR组患者中,使用非布司他治疗的患者主要终点人数与对照组相比明显减少,差异具有统计学意义,而在高GFR组患者中,两组主要终点人数差异无统计学意义。与对照组相比,治疗组患者血清MCP-1及IL-6水平明显降低,对比差异具有统计学意义。结论:非布司他可明显延缓CKD3-4期合并高尿酸血症患者的肾功能进展并降低患者的炎症水平,起到保护肾脏作用。Objective:To analyze the clinical effects of febuxostat on chronic kidney disease (CKD) stage III with hyperuricemia and its inflammatory levels.Methods:According to the use of uric acid drugs,136 patients were divided into the treatment group (70 patients) and control group (66 patients) in addition to conventional medication.The treatment group was given febuxostat (40 mg daily);the control group was given allopurinol or other reducing uric acid drug treatment.The primary endpoint was defined as GFR decreased by 10% at least compared with baseline.Results:After 6 months,there was no significant difference in serum uric acid levels between groups (P>0.05). Compared with baseline,there was no significant difference of GFR level in the treatment group (P>0.05),but the level of GFR in the control group was significantly decreased (P<0.05).All patients were divided into the high GFR group (GFR ≥ 45 mL/(min · 1.73m^2)) and low GFR group (GFR ≤ 45 mL/(min · 1.73m^2)) according to the GFR level.The number of patients recevied febuxostat in low GFR group reached the primary endpoint was significantly lower than the control group (P<0.05).There was no significant difference in the number of the primary endpoints of the two groups in the patients of high GFR group (P>0.05).Compared with the control group,the serum MCP-1 and IL-6 levels in the treatment group were significantly reduced,and the difference was statistically significant (P<0.05). Conclusion:Febuxostat can significantly delay the progression of renal function in patients with CKD 3-4 and hyperuricemia and reduce the inflammatory level of patients,which play a protective role in the kidneys.

关 键 词：非布司他 慢性肾脏病 高尿酸血症 临床效果 炎症 

分 类 号：R692[医药卫生—泌尿科学]