不同剂量非布司他治疗尿酸性终末期肾病患者的临床疗效  

Clinical Efficacy of Different Doses Febuxostat in the Treatment of Uric Acid End-stage Nephropathy

作　　者：殷俊 邱君思[1] 邵芳 YIN Jun;QIU Jun-si;SHAO Fang(Department of Nephrology,Wuxi Second People's Hospital,Wuxi Jiangsu 214000,China)

机构地区：[1]无锡市第二人民医院肾内科,江苏无锡214000

出　　处：《医学临床研究》2022年第3期439-441,共3页Journal of Clinical Research

摘　　要：【目的】探讨不同剂量非布司他治疗尿酸性终末期肾病(UAESN)患者的临床疗效。【方法】在本院治疗的UAESN患者98例,随机分为观察组(n=49)与对照组(n=49)。在常规治疗基础上,观察组给予20 mg非布司他治疗,对照组给予40 mg非布司他治疗。观察两组治疗前后血肌酐(SCr)、肾小球滤过率(eGFR)及尿微量清蛋白与肌酐比值(ACR)等肾功能指标;血尿酸(SUA)及血浆黏度(PV)、全血低切黏度(ηL)、全血高切黏度(ηH)等血液流变学指标;丙二醛(MDA)、晚期氧化蛋白产物(AOPP)及超氧化物歧化酶(SOD)等氧化应激指标的变化。比较两组患者的疗效及不良反应。【结果】与治疗前相比,治疗后两组SCr、ACR均降低,eGFR、SOD均升高,SUA、PV、ηL、ηH、MDA、AOPP均降低(P<0.05)。治疗后两组SCr、ACR、eGFR、SUA、PV、ηL、ηH、MDA、AOPP及SOD比较差异均无统计学意义(P>0.05)。观察组总有效率(91.84%)与对照组(95.92%)比较差异无统计学意义(P>0.05)。观察组不良反应发生率低于对照组(P<0.05)。【结论】在常规治疗基础上,20 mg非布司他治疗UAESN在改善患者肾功能、血液流变学指标,缓解氧化应激,临床疗效等方面与40 mg非布司他效果一致,但使用20 mg非布司他治疗安全性更高。【Objective】To investigate the clinical effects of febuxostat at different doses in the treatment of uric acid end-stage nephropathy(UAESN).【Methods】A total of 98 UAESN patients treated in our hospital were selected and randomly divided into the observation group(n=49)and the control group(n=49).On the basis of conventional treatment,the observation group was given 20 mg febuxostat,and the control group was given 40mg febuxostat.Serum creatinine(SCr),glomerular filtration rate(eGFR),urinary microalbumin to creatinine ratio(ACR)and serum uric acid(SUA)were observed before and after treatment.Plasma viscosity(PV),whole blood low shear viscosity(ηL),whole blood high shear viscosity(ηH),malondialdehyde(MDA),advanced oxide protein product(AOPP),superoxide dismutase(SOD)and other oxidative stress indicators were recorded.The efficacy and adverse reactions of the two groups were compared.【Results】Compared with before treatment,SCr and ACR were decreased,eGFR and SOD were increased,SUA,PV,ηL,ηH,MDA and AOPP were decreased after treatment(P<0.05).After treatment,there were no significant differences in SCr,ACR,eGFR,SUA,PV,ηL,ηH,MDA,AOPP and SOD between the two groups(P>0.05).There was no significant difference between the clinical efficacy of the observation group(91.84%)and the control group(95.92%)(P>0.05).The incidence of adverse reactions in the observation group was lower than that in the control group(P<0.05).【Conclusion】Based on conventional treatment,20 mg febuxostat has the same effect as 40 mg febuxostat in aspect of improving renal function,hemorheology,relieving oxidative stress and clinical efficacy of UAESN,however,20 mg febuxostat has better safety.

关 键 词：肾疾病/并发症 高尿酸血症/并发症 高尿酸血症/药物疗法 抗痛风药/治疗应用 

分 类 号：R692[医药卫生—泌尿科学]