非布司他对无症状高尿酸血症透析患者心脑血管事件及血清学指标的影响  

The study of febuxostat on cardiovascular and cerebrovascular events and serological indexes of asymptomatic hyperuricemia patients with hemodialysis

作　　者：梁霄 杨定位 武子霞[2] 张笑笑 王盼[3] LIANG Xiao;YANG Ding-wei;WU Zi-xia;ZHANG Xiao-xiao;WANG Pan(Orthopedic Clinical Hospital,Tianjin Medical University,Tianjin 300211,China;Department of Nephrology,Tianjin Hospital,Tianjin 300200,China;Affiliated Hospital of Hebei University,Baoding 071000,China)

机构地区：[1]天津医科大学骨科临床医院,天津300211 [2]天津医院肾内科,天津300200 [3]河北大学附属医院,保定071000

出　　处：《天津医科大学学报》2021年第6期564-568,共5页Journal of Tianjin Medical University

摘　　要：目的:探讨非布司他对维持性血透伴无症状高尿酸血症患者心脑血管事件及部分血清学指标的影响。方法:收集2017年12月—2018年12月天津医院收治的维持性血透伴无症状高尿酸血症患者80例为研究对象,年龄≥40岁,采用单中心、随机、开放、平行对照试验设计,患者按1∶1比例随机分配至非布司他试验组和空白对照组,试验组在常规治疗基础上增加非布司他治疗,对照组只进行基础治疗,每组各40例。对两组患者随访1年期间心脑血管终点事件进行统计。检测患者治疗前后的血糖(GLU)、血尿酸(SUA)、血肌酐(Scr)、总胆固醇(TC)、甘油三酯(TG)、血管内皮功能指标水平。对两组患者治疗期间不良反应发生率进行比较。结果:在为期1年的随访试验中,试验组心血管事件发生率、因心血管事件再住院率、脑血管事件发生率、因脑血管事件再住院率、全因死亡率均低于对照组(χ^(2)=6.144、5.625、5.584、4.800、4.043,均P<0.05)。治疗后试验组SUA水平低于对照组(t=2.886,P<0.05),两组GLU、Scr、TC、TG间差异无统计学意义(t=0.648、0.373、0.364、0.301,均P>0.05)。治疗后试验组血管内皮功能指标一氧化氮(NO)、血管内皮素-1(ET-1)、髓过氧化物酶(MPO)水平均低于对照组(t=4.982、3.896、4.651,均P<0.05)。试验组、对照组不良反应发生率差异无统计学意义(χ^(2)=0.784,P>0.05)。结论:非布司他能够改善维持性血透伴无症状高尿酸血症患者的预后,降低患者心脑血管不良事件发生率,降低SUA等血清学指标,可能与改善血管内皮功能有关。Objective:To evaluate the impact of febuxostat on cardiovascular and cerebrovascular events and some serological indicators in patients with maintenance hemodialysis accompanied by asymptomatic hyperuricemia.Methods:From December 2017 to December 2018,80 patients with maintenance hemodialysis accompanied by asymptomatic hyperuricemia in Tianjin Hospital,age≥40 years old,were collected.Using a single-center,randomized,open,parallel controlled trial design,patients were randomly assigned to the febuxostat experimental group and the blank control at a 1∶1 ratio.In the experimental group,febuxostat was added to the conventional treatment,and the control group received only basic treatment,with 40 cases in each group.The cardiovascular and cerebrovascular end-point events during the 1 year follow-up of the two groups were statistically compared.Blood glucose(GLU),serum uric acid(SUA),serum creatinine(SCR),total cholesterol(TC),triglyceride(TG)and vascular endothelial function index were measured before and after treatment.The incidence of adverse reactions was compared between the two groups.Results:During the one-year follow-up observation,the incidence of cardiovascular events,readmission rate due to cardiovascular events,cerebrovascular events,readmission rate due to cerebrovascular events and all-cause mortality rate in the experimental group were lower than those in the control group,and the differences between the two groups were statistically significant(χ^(2)=6.144,5.625,5.584,4.800,4.043,all P<0.05).After treatment,the SUA level of the experimental group was lower than that of the control group(t=2.886,P<0.05),and there were no differences in GLU,SCR,TC,TG between the two groups(t=0.648,0.373,0.364,0.301,all P>0.05).The vascular endothelial function indexes of patients in the experimental group including nitric oxide(NO),vascular endothelin-1(ET-1),and myeloperoxidase(MPO)levels were lower than those in the control group(t=4.982,3.896,4.651,all P<0.05).And there was no significant difference in the incid

关 键 词：血液透析 无症状高尿酸血症 非布司他 预后 心脑血管疾病 

分 类 号：R614[医药卫生—麻醉学]