非布司他和别嘌呤醇治疗KDIGO分级4~5期慢性肾病伴高尿酸血症的临床效果比较  

Comparison of clinical effect of Febuxostat and Allopurinol in the treatment of KDIGO grade four to five chronic nephropathy with hyperuricemia

作　　者：张谊雯 张立元[1] 过轶斌 ZHANG Yiwen;ZHANG Liyuan;GUO Yibin(Department of Nephrology,the First People’s Hospital of Lianyungang City,Jiangsu Province,Lianyungang 222000,China;Lianyungang College Affiliated to Xuzhou Medical University,Jiangsu Province,Lianyungang 222000,China)

机构地区：[1]江苏省连云港市第一人民医院肾内科,江苏连云港222000 [2]徐州医科大学附属连云港学院,江苏连云港222000

出　　处：《中国医药导报》2021年第3期62-66,共5页China Medical Herald

基　　金：江苏省第五期“333工程”科研项目(BRA2018274)。

摘　　要：目的探讨非布司他和别嘌呤醇治疗KDIGO分级4~5期慢性肾病(CKD)伴高尿酸血症(HUA)的临床效果。方法选取2016年8月—2019年1月于连云港市第一人民医院收治的134例KDIGO分级4~5期CKD伴HUA患者,依据随机数字表法分为别嘌呤醇组和非布司他组,每组67例,疗程6个月。比较两组治疗第1~6个月血尿酸(SUA)达标率、不良反应及治疗前后体重指数、收缩压、总胆固醇(TC)、三酰甘油、低密度脂蛋白胆固醇(LDL-C)、SUA、尿素氮(BUN)、血清肌酐(Scr)、估算的肾小球滤过率(eGFR)、24 h尿蛋白。结果非布司他组治疗第1、2、3、4、5、6个月SUA达标率均高于别嘌呤醇组,差异有统计学意义(P<0.05)。治疗后6个月,非布司他组不良反应发生率低于别嘌呤醇组,差异有统计学意义(P<0.05)。治疗后,非布司他组TC、LDL-C、SUA、BUN、Scr、24 h尿蛋白均低于治疗前及别嘌呤醇组,eGFR高于治疗前及别嘌呤醇组,差异有统计学意义(P<0.05);治疗后,别嘌呤醇组BUN低于治疗前,差异有统计学意义(P<0.05)。结论非布司他能降低KDIGO分级4~5期CKD伴HUA患者的SUA水平,减少Scr和蛋白尿,改善肾功能。Objective To investigate clinical effect of Febuxostat and Allopurinol in the treatment of KDIGO grade four to five chronic nephropathy(CKD)with hyperuricemia(HUA).Methods One hundred and thirty-four patients with CKD and HUA of KDIGO grade four to five admitted to the First People’s Hospital of Lianyungang City from August 2016 to January 2019 were selected and divided into allopurinol group and febuxostat group according to random number table method,with 67 cases in each group.The course of treatment was six months.The standard rate of serum uric acid(SUA)in the first to six months of treatment,adverse reaction,body mass index,systolic blood pressure,total cholesterol(TC),triglyceride,low density lipoprotein-cholesterol(LDL-C),SUA,blood urea nitrogen(BUN),serum creatinine(Scr),estimate glomerular filtration rate(eGFR)and 24 h urinary protein before and after treatment were compared between two groups.Results The standard rate of SUA in febuxostat group was higher than that in allopurinol group at one,two,three,four,five and six months after treatment,the differences were statistically significant(P<0.05).Six months after treatment,the incidence rate of adverse reaction in febuxostat group was lower than that in allopurinol group,the difference was statistically significant(P<0.05).After treatment,TC,LDL-C,SUA,BUN,Scr and 24 hours urinary protein in febuxostat group were lower than those before treatment and allopurinol group,and eGFR in febuxostat group was higher than that before treatment and allopurinol group,the differences were statistically significant(P<0.05).After treatment,BUN in allopurinol group was significantly lower than that before treatment,the difference was statistically significant(P<0.05).Conclusion Febuxostat can reduce the SUA level of CKD and HUA patients with grade four to five of KDIGO,reduce Scr and proteinuria,and improve renal function.

关 键 词：KDIGO分级 慢性肾病 高尿酸血症 非布司他 别嘌呤醇 

分 类 号：R692[医药卫生—泌尿科学]