不同剂量非布司他治疗终末期肾病伴高尿酸血症患者的临床疗效及安全性  

Clinical efficacy and safety of febuxostat in different doses foRtreating patients with end-stage renal disease and concomitant hyperuricemia

作　　者：佘秋如 陈茹芳[1] 刘喜霞 SHE Qiu-ru;CHEN Ru-fang;LIU Xi-xia(Western Pharmacy of Pharmacy Department,Bao′an District People′s Hospital of Shenzhen,Shenzhen 518101,Guangdong,China)

机构地区：[1]深圳市宝安区人民医院药学部西药房,广东省深圳市518101

出　　处：《广西医学》2022年第21期2484-2487,2492,共5页Guangxi Medical Journal

基　　金：广东省深圳市宝安区科技计划项目(20180402101529793)。

摘　　要：目的探讨不同剂量的非布司他治疗终末期肾病伴高尿酸血症患者的临床疗效及安全性。方法选取100例终末期肾病伴高尿酸血症患者,将其随机分为A组和B组,各50例。A组、B组患者在接受基础治疗的同时分别口服40 mg/次、20 mg/次的非布司他,均1次/d,疗程为3个月。比较两组患者治疗前后的血尿酸水平、血肌酐水平、估算肾小球滤过率(eGFR)、尿微量白蛋白与肌酐比值(ACR),以及血清超敏C反应蛋白(hs-CRP)、胎球蛋白A、成纤维细胞生长因子-23(FGF-23)水平。评估两组患者的临床疗效及不良反应发生情况。结果治疗3个月后,两组患者的血尿酸水平、ACR,以及血清hs-CRP、胎球蛋白A、FGF-23水平均较治疗前改善(均P<0.05),但两组间差异均无统计学意义(均P>0.05);各组内eGFR、ACR治疗前后比较,以及治疗后两组间比较,差异均无统计学意义(均P>0.05)。治疗后,两组临床疗效差异无统计学意义(P>0.05)。B组的不良反应发生率为8.00%,低于A组的22.00%(P<0.05)。结论应用剂量为20 mg和40 mg的非布司他治疗终末期肾病伴高尿酸血症患者的临床疗效相当,但是20 mg非布司他的不良反应发生率更低。Objective To explore the clinical efficacy and safety of febuxostat in different doses foRtreating patients with end-stage renal disease and concomitant hyperuricemia.Methods A total of 100 patients with end-stage renal disease and concomitant hyperuricemia were selected,and they were randomly divided into group A oRgroup B,with 50 cases in each group.When the patients of groups A and B received basic treatment,they were simultaneously administrated orally febuxostat of 40 mg peRtime,20 mg peRtime,respectively,with once peRday,foRa 3-month disease course.The blood uric acid level,serum creatinine level,and estimating glomerulaRfiltration rate(eGFR),urine microalbumin-to-creatinine ratio(ACR),as well as serum high-sensitivity C reactive protein(hs-CRP),fetuin A,fibroblast growth factor-23(FGF-23)levels were compared between the two groups.The clinical efficacy and occurrence of adverse reactions were evaluated in the two groups.Results AfteR3 months of treatment,the blood uric acid level,ACR,and levels of serum hs-CRP,fetuin A,and FGF-23 in both groups were ameliorated as compared with before treatment(all P<0.05);however,there was no statistically significant difference between the two groups(all P>0.05).There were no statistically significant differences in eGFRand ACRof various groups between before and afteRtreatment,and between the two groups afteRtreatment(all P>0.05).AfteRtreatment,no statistically significant difference in clinical efficacy between the two groups was found(P>0.05).The incidence rate of adverse reactions in group B was 8.00%,which was loweRthan that in group A(22.00%,P<0.05).Conclusion The clinical efficacy of applying 20 mg and 40 mg febuxostat to the treatment of patients with end-stage renal disease and concomitant hyperuricemia is equivalent,but the incidence rate of adverse reactions of 20 mg febuxostat is lower.

关 键 词：终末期肾病 高尿酸血症 非布司他 剂量 临床疗效 不良反应 

分 类 号：R692.5[医药卫生—泌尿科学] R589.7[医药卫生—外科学] R94[医药卫生—临床医学]