低嘌呤饮食联合碳酸氢钠、非布司他治疗肥胖合并高尿酸血症的临床研究  

Clinical study on the treatment of obesity with hyperuricemia by low purine diet combined with sodium bicarbonate and non bustard

作　　者：夏丽芳[1] 何倩[1] 王鑫[1] 周雪[1] 宋茜茜 张月娥[1] 李志红[1] XIA Li-fang;HE Qian;WANG Xin(Department of Endocrinology,Baoding First Central Hospital,Baoding Hebei 071400,China)

机构地区：[1]保定市第一中心医院内分泌科,河北保定071400

出　　处：《临床和实验医学杂志》2021年第2期176-180,共5页Journal of Clinical and Experimental Medicine

基　　金：河北省卫生厅医学科学研究重点课题计划项目(编号:ZL20140182);2017年保定市科学技术研究与发展指导计划项目(编号:17ZF164)。

摘　　要：目的探究低嘌呤饮食联合碳酸氢钠、非布司他治疗肥胖合并高尿酸血症的临床疗效。方法前瞻性选取2018年1月至2019年3月保定市第一中心医院收治的肥胖合并高尿酸血症患者124例,采用随机数字表法分为观察组与对照组,对照组采用低嘌呤饮食治疗,观察组在对照组基础上联合碳酸氢钠、非布司他治疗。对比2组患者治疗前和治疗后3个月的体质指数(BMI)、血压、糖脂代谢[空腹血糖(FPG)、总胆固醇(TC)、总甘油三酯(TG)]、胰岛素抵抗[空腹胰岛素(INS)、稳态模型胰岛素抵抗指数(HOMA-IR)]、血尿酸、肾功能及不良反应发生情况。结果2组患者BMI组间与组内比较,差异无统计学意义(P>0.05);治疗后3个月,观察组收缩压与舒张压均明显低于对照组(P<0.05);治疗后3个月,2组患者FPG、TC、TG水平均较治疗前下降,观察组明显低于对照组(P<0.05);治疗后3个月,观察组INS与HOMA-IR明显低于对照组(P<0.05),对照组INS与HOMA-IR组内比较差异无统计学意义(P>0.05);治疗后3个月,2组患者尿酸与血肌酐均较治疗前下降,观察组明显低于对照组(P<0.05);观察组急性痛风发作率明显低于对照组(6.45%vs.20.97%,P<0.05),2组患者丙氨酸转移酶升高及腹泻发生率比较,差异无统计学意义(3.23%vs.4.84%,6.45%vs.3.23%,P>0.05)。结论低嘌呤饮食联合碳酸氢钠、非布司他可有效纠正肥胖合并高尿酸血症患者糖脂代谢紊乱,降低胰岛素抵抗,提高肾功能,且安全性较高。Objective To explore the effects of low purine diet combined with sodium bicarbonate and febupropath on glucose and lipid metabolism,insulin resistance and renal function in obese patients with hyperuricemia.Methods One hundred and twenty four patients with obesity complicated with hyperuricemia admitted to Baoding First Central Hospital from January 20 to March 2019 were divided into observation group and control group according to random number table method.The control group was treated with low purine diet,and the observation group was treated with sodium bicarbonate and febupropathrin on the basis of the control group.The body mass index(BMI),blood pressure,glycolipid metabolism[fasting blood glucose(FPG),total cholesterol(TC),total triglycerides(TG)],insulin resistance[insulin(INS),homeostatic model insulin resistance index(HOMA-IR)],serum uric acid(UA),renal function and adverse reactions were compared between the two groups before treatment and 3 months after treatment.Results There was no significant difference in BMI between the two groups before and after treatment(P>0.05).while the systolic and diastolic blood pressures in the observation group were significantly lower than those in the control group(P<0.05).After treatment,the levels of FPG,TC and TG in the two groups were lower than those before treatment(P<0.05),and the observation group was significantly lower than the control group(P<0.05).After treatment,INS and HOMA-IR in the observation group were significantly lower than those in the control group(P<0.05),while there was no significant difference between INS and HOMA-IR in the control group(P>0.05).After treatment,UA and Scr in both groups decreased compared with those before treatment,and those in the observation group were significantly lower than those in the control group(P<0.05).The incidence of acute gout in the observation group was significantly lower than that in the control group(6.45%vs.20.97%,P<0.05),while there was no significant difference in the incidence of elevated alanine ami

关 键 词：肥胖合并高尿酸血症 嘌呤饮食 碳酸氢钠 非布司他 糖脂代谢 胰岛素抵抗 肾功能 

分 类 号：R589.7[医药卫生—内分泌] R589.2[医药卫生—内科学]