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作 者:刘正萌 刘小菊 李蓉 Liu Zhengmeng;Liu Xiaoju;Li Rong(Department of Nephrology,Guangyuan Central Hospital,Guangyuan 628000,China;Hemodialysis Center,Chongqing General Hospital,Chongqing 401147,China)
机构地区:[1]四川省广元市中心医院肾病内科,广元628000 [2]重庆市人民医院血透中心,重庆401147
出 处:《成都医学院学报》2025年第1期70-73,共4页Journal of Chengdu Medical College
基 金:四川省卫生健康委员会科研项目(No:20PJ280)。
摘 要:目的探讨应用非布司他联合枸橼酸钾颗粒治疗痛风伴高尿酸血症肾结石的效果。方法选取2020年9月至2024年1月四川省广元市中心医院收治的痛风伴高尿酸血症肾结石患者122例为研究对象,按照随机数字表法分为3组,A组(42例)采用枸橼酸钾颗粒联合非布司他(80 mg/d)治疗,B组(42例)采用枸橼酸钾颗粒联合非布司他(40 mg/d)治疗,C组(30例)采用枸橼酸钾颗粒治疗。比较3组临床疗效、疼痛改善程度、微炎状态及细胞因子、肾功能指标、不良反应及预后。结果A组总有效率高于B、C组(P<0.05);A组治疗3个月后疼痛视觉模拟(VAS)评分均低于B、C组(P<0.05);治疗后A组白细胞介素-1β(IL-1β)、肿瘤坏死细胞-α(TNF-α)、血清超敏C-反应蛋白(hs-CRP)、血管内皮素-1(ET-1)、可溶性细胞间黏附分子-1(sICAM-1)、血清尿素氮(BUN)、血肌酐(Scr)、血尿酸均低于B、C组(P<0.05);3组不良反应发生率、结石复发率比较差异无统计学意义(P>0.05),A组痛风发作频率低于B、C组(P<0.05)。结论非布司他联合枸橼酸钾颗粒有助于改善痛风伴高尿酸血症肾结石疗效,降低炎症水平,改善肾功能,大剂量非布司他疗效及预后更优,且具有一定的安全性。Objective To investigate the efficacy of febuxostat combined with potassium citrate granules in the treatment of patients with gout,hyperuricemia and kidney stones.Method A total of 122 patients with gout,hyperuricemia and kidney stones admitted to Guangyuan Central Hospital from September 2020 to January 2024 were included.They were randomly divided into three groups according to a random number table method.Group A(n=42)was treated with combination therapy of febuxostat(80 mg/d)and potassium citrate granules,Group B(n=42)was treated with combination therapy of febuxostat(40 mg/d)and potassium citrate granules,while Group C(n=30)was treated with potassium citrate granules alone.The clinical efficacy,degree of pain relief,micro-inflammatory status,cytokines,renal function indicators,adverse reactions,and prognosis were compared between the three groups.Results The total effective rate in Group A was higher than that in Group B and Group C(P<0.05).The Visual Analog Scale(VAS)scores in Group A were lower than those in Group B and Group C after 3 months of treatment(P<0.05).After treatment,the levels of interleukin-1β(IL-1β),tumor necrosis factor-α(TNF-α),serum high-sensitivity C-reactive protein(hs-CRP),endothelin-1(ET-1),soluble intercellular adhesion molecule-1(sICAM-1),serum blood urea nitrogen(BUN),serum creatinine(Scr),and serum uric acid in Group A were all lower than those in Group B and Group C(P<0.05).There was no significant difference in the incidence of adverse reactions and recurrence rate of kidney stones among the three groups(P>0.05).During follow-up,the frequency of gout attacks in Group A was lower than that in Group B and Group C(P<0.05).Conclusion The combination of febuxostat and potassium citrate granules can help improve the efficacy in the treatment of patients with gout,hyperuricemia and kidney stones by,reducing inflammation levels,and improving kidney function.And high-dose febuxostat has better efficacy and prognosis,as well as certain safety.
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