不同剂量非布司他对3~5期慢性肾衰竭伴高尿酸血症MHD患者微炎症状态的影响  

The Impact of Different Doses of Febuxostat on the Micro-Inflammatory State in Patients with Stage 3-5 Chronic Kidney Disease and Hyperuricemia Undergoing Maintenance Hemodialysis

作　　者：刘琼[1] 华琪[1] 周芸 LIU Qiong;HUA Qi;ZHOU Yun(Department of Pharmacy,Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine,Shanghai 200021)

机构地区：[1]上海中医药大学附属曙光医院药学部,上海200021

出　　处：《医学临床研究》2024年第8期1132-1134,共3页Journal of Clinical Research

摘　　要：【目的】探讨不同剂量非布司他治疗对3~5期慢性肾衰竭伴高尿酸血症维持性血液透析(MHD)患者微炎症状态的影响。【方法】114例3~5期慢性肾衰竭伴高尿酸血症MHD患者,随机分为A组、B组和C组,每组38例。A组给予非布司他片口服给药,40 mg/d;B组给予非布司他片口服给药,80 mg/d;C组给予别嘌呤醇片口服给药,300 mg/d。比较三组患者治疗24周后的临床疗效、血清指标及给药期间的药物不良反应。【结果】三组患者的临床疗效比较,差异均无统计学意义(P>0.05)。治疗后,三组患者的血尿酸、内皮素-1(ET-1)、白细胞介素-10(IL-10)、中性粒细胞弹性蛋白酶(NE)水平较治疗前均降低(P<0.05),但组间比较,差异均无统计学意义(P>0.05)。三组不良反应发生率比较,差异无统计学意义(P>0.05)。【结论】不同剂量非布司他治疗3~5期慢性肾衰竭伴高尿酸血症MHD患者,均可改善微炎症状态,降低血尿酸水平,疗效显著且安全性良好,临床应根据患者具体情况进行治疗。【Objective】To investigate the effects of different doses of febuxostat on the micro-inflammatory state in patients with stage 3-5 chronic kidney disease(CKD)accompanied by hyperuricemia undergoing maintenance hemodialysis(MHD).【Methods】A total of 114 patients undergoing MHD with stage 3-5 CKD and hyperuricemia were randomly divided into three groups:Group A(38 patients),treated with 40 mg/day of oral febuxostat;Group B(38 patients),treated with 80 mg/d of oral febuxostat;and Group C(38 patients),treated with 300 mg/d of oral allopurinol.After 24 weeks of treatment,the clinical efficacy,serum markers,and adverse drug reactions during the treatment period were compared among the three groups.【Results】There were no statistically significant differences in clinical efficacy among the three groups(P>0.05).After treatment,the levels of serum uric acid,endothelin-1(ET-1),interleukin-10(IL-10),and neutrophil elastase(NE)decreased in all groups(P<0.05),but there were no statistically significant differences between the groups(P>0.05).The incidence of adverse reactions was also not significantly different among the groups(P>0.05).【Conclusion】Different doses of febuxostat in patients undergoing MHD with stage 3-5 CKD and hyperuricemia can improve the micro-inflammatory state and reduce serum uric acid levels,with good efficacy and safety.Clinical treatment should be tailored to the specific circumstances of the patient.

关 键 词：肾功能衰竭 慢性/药物疗法 抗痛风药/投药和剂量 高尿酸血症 肾透析 

分 类 号：R692.5[医药卫生—泌尿科学]