不同降尿酸方案治疗吡嗪酰胺所致高尿酸血症效果比较研究  

Comparative study on uric acid lowering effects of different regimens on pyrazinamide induced hyperuricemia

作　　者：苏伶伶 郑梅琴[2] 许瑞[2] 刘秋月[3] 郭振勇[2] 刘硕[2] SU Lingling;ZHENG Meiqin;XU Rui;LIU Qiuyue;GUO Zhenyong;LIU Shuo(Department of General,Beijing Chest Hospital,Capital Medical University,Beijing101149,China;Department of Pharmacy,Beijing Chest Hospital,Capital Medical University,Beijing101149,China;Intensive Care Unit,Beijing Chest Hospital,Capital Medical University,Beijing101149,China)

机构地区：[1]首都医科大学附属北京胸科医院综合科,北京101149 [2]首都医科大学附属北京胸科医院药学部,北京101149 [3]首都医科大学附属北京胸科医院重症医学科,北京101149

出　　处：《中国医药导报》2023年第34期101-104,共4页China Medical Herald

基　　金：国家自然科学基金青年科学基金资助项目(82100011)。

摘　　要：目的 比较不同干预方案对吡嗪酰胺致高血尿酸血症的降尿酸效果。方法 检索首都医科大学附属北京胸科医院2012年1月至2022年12月吡嗪酰胺致高尿酸血症不良反应报告。收集患者基本信息和血尿酸水平,按降尿酸方式将患者分为苯溴马隆治疗组(74例)、生活方式干预组(31例)、停用吡嗪酰胺组(25例)和别嘌醇治疗组(4例)。以各组血尿酸水平变化率为指标,通过单因素方差分析比较各组降尿酸效果。结果 纳入患者134例,其中男91例(67.9%);中位年龄30(22,51)岁;体重(58.8±11.8)kg;身高(169.1±7.4)cm;采用一线抗结核治疗方案的107例(79.9%);应用吡嗪酰胺天数7(6,9)d;有药物过敏史患者22例(16.4%)。四组干预后第3~5周的血尿酸、降尿酸干预后尿酸变化率比较,差异有统计学意义(P<0.05)。其中,苯溴马隆治疗组、生活方式干预组、别嘌醇治疗组干预后第3~5周的血尿酸、降尿酸干预后尿酸变化率高于停用吡嗪酰胺组,生活方式干预组降尿酸干预后尿酸变化率高于苯溴马隆治疗组,差异有统计学意义(P<0.05)。结论 四种降低血尿酸的方案中停用吡嗪酰胺最有效,使用苯溴马隆也能够降低尿酸,生活方式干预的降尿酸效果不如以上两种方案。Objective To compare the effect of different intervention schemes on lowering uric acid in pyrazinamide induced hyperuricemia.Methods The adverse reaction reports of pyrazinamide induced hyperuricemia in Beijing Chest Hospital Affiliated to Capital Medical University from January 2012 to December 2022 were searched.The basic information and blood uric acid level of the patients were collected,and the patients were divided into benbromarone treatment group(74 cases),lifestyle intervention group(31 cases),pyrazinamide disuse group(25 cases)and allopurinol treatment group(4 cases)according to the way of lowering uric acid.Using the change rate of blood uric acid level as index,the effect of lowering uric acid in each group was compared by one-way ANOVA.Results A total of 134 patients were included,including 91 males(67.9%).The median age was 30(22,51)years;body weight(58.8±11.8)kg;height(169.1±7.4)cm;107 cases(79.9%)were treated with first-line anti-tuberculosis therapy.Days of application of pyrazinamide 7(6,9)days;there were 22 patients(16.4%)with history of drug allergy.There were significant differences in blood uric acid at 3 to 5 weeks after the intervention and the change rate of uric acid after the intervention(P<0.05).Among them,the change rate of blood uric acid in benbromarone treatment group,lifestyle intervention group and allopurinol treatment group at 3 to 5 weeks after intervention was higher than that of pyrazinamide disuse group,and the change rate of uric acid in lifestyle intervention group was higher than that of benbromarone treatment group,with statistical significances(P<0.05).Conclusion Among the four programs to reduce blood uric acid,the withdrawal of pyrazinamide is the most effective,and the use of benzbromarone can also reduce uric acid,but the effect of lifestyle intervention is not as good as the above two programs.

关 键 词：结核病 吡嗪酰胺 不良反应 高尿酸血症 降尿酸治疗 

分 类 号：R587[医药卫生—内分泌]