ARNI/ARB类药物及中医证型对合并心力衰竭的急性痛风发作患者住院转归的预后评价  

Prognostic evaluation of ARNI/ARB drugs and traditional Chinese medicine(TCM) syndrome types on hospitalization outcomes of acute gout attacks complicated with heart failure

作　　者：任强[1] 雍婧 陈俞池 李雪萍[1] REN Qiang;YONG Jing;CHEN Yu-ci;LI Xue-ping(The Affiliated Hosipital of Chengdu University of Traditional Chinese Medicine,Chengdu 610032,Sichuan;The First Orthpedics Hospital of Chengdu,Chengdu 610074,Sichuan)

机构地区：[1]成都中医药大学附属医院,四川成都610032 [2]成都第一骨科医院,四川成都610074

出　　处：《中药与临床》2023年第5期71-74,共4页Pharmacy and Clinics of Chinese Materia Medica

基　　金：四川省中医药管理局科学技术研究专项课题(2021MS119)。

摘　　要：目的:探索ARNI/ARB类药物及不同中医证型对合并心力衰竭的痛风患者住院转归的预后作用。方法:回顾性纳入成都中医药大学附属医院2021.1-2023.1期间合并心力衰竭的痛风住院患者112例,其中非利尿剂诱发的急性发作期的患者56例(A组),经利尿治疗诱发痛风的患者56例(B组),以痛风症状改善为结局变量,分别采用COX回归分析及Kplan-meier分析法探索住院期间脑利钠肽、心功能分级、ARNI/ARB、利尿剂用量对患者预后的干预情况。结果:使用ARNI类药物较ARB类药物能更显著的改善合并心衰的急性痛风患者的结局(p<0.05),特别是非利尿剂诱导的急性痛风患者。中医证型是两组患者症状好转的独立危险因素(p<0.05)。结论:使用ARNI类药物能更好的改善非利尿剂诱导的急性痛风结局,但对使用利尿剂的患者无益。B组的脾虚湿热证的患者具有更早出院倾向。Objective:To explore the prognostic effect of ARNI/ARB drugs and different TCM syndrome types on the hospitalization outcome of gout patients with heart failure.Method:Retrospective inclusion of 112 hospitalized gout patients with heart failure at our hospital from January 2021 to January 2023 were included.Among them,56 patients with non-diureticinduced acute exacerbation were included in group A.56 patients with diuretic treatment induced gout were included in group B.The improvement of gout symptoms was used as the outcome variable.The COX regression analysis and Kaplan-Meier analysis were used to explore the intervention of brain natriuretic peptide,heart function grading,ARNI/ARB,and diuretic usage during hospitalization on the prognosis of patients.Result:Compared with ARB drugs,ARNI could significantly improve the outcome of acute gout patients with heart failure(p <0.05),especially for non-diuretic induced acute gout patients.TCM syndrome type was an independent risk factor for symptom improvement in the two groups(p< 0.05).Conclusion:The use of ARNI can better improve the outcome of non-diuretic induced acute gout,but it is not beneficial for patients using diuretics.Patients with spleen deficiency and dampness-heat syndrome in group B tended to be discharged earlier.

关 键 词：心力衰竭 痛风 沙库巴曲缬沙坦 中医证型 

分 类 号：R242[医药卫生—中医临床基础]