非布司他治疗原发性痛风合并轻中度肾功能不全的临床疗效

目的:探讨非布司他治疗原发性痛风合并轻中度肾功能不全的患者的临床疗效及安全性。方法:选取2015年1月至2016年8月于南京中医药大学附属中西医结合医院收治的原发性痛风合并轻中度肾功能不全的男性患者60例,随机分为两组,每组30例。对照组接受别嘌呤醇治疗,观察组接受非布司他治疗。比较两组患者治疗期间血尿酸(BUA)以及肝肾功能的变化,同时记录两组患者治疗期间的不良反应以及痛风再发作次数。结果:治疗后第1月、第2月及第3月,观察组患者的血尿酸水平均显著低于对照组(P0.05)。两组患者治疗后肾功能均较治疗前显著改善(P0.05),但两组之间比较差异无统计学意义(P0.05);治疗3个月内,两组均有痛风再发作,其发生率比较差异无统计学意义(P0.05);对照组患者有四肢不适、嗜睡、恶心、腹胀、腹泻、皮肤瘙痒等不良反应的发生,观察组有四肢不适、嗜睡、腹胀等不良反应的出现,其中对照组有1例出现过敏性皮疹停用别嘌醇。观察组的总发生率显著低于对照组(P0.05)。结论:非布司他治疗原发性痛风合并轻中度肾功能不全患者可安全、有效地降低血尿酸水平,并改善患者肾功能。

Clinical Effect of Febuxosta on the Patients with Primary Gout Complicated with Mild to Moderate Renal Insufficiency

ABSTRACT Objective: To explore the curative effect and safety of febuxosta for the patients with primary gout complicated with mild to moderate renal insufficiency. Methods: 60 male patients with primary gout complicated with mild to moderate renal insufficiency were enrolled in the affiliated Hospital of integrated traditional Chinese and Western Medicine, Nanjing University of Chinese Medicine from January 2015 to August 2016 and randomly divided into two groups, the control group (n=30) was treated by allopurinol, and the study group (n=30) was treated by febuxosta treatment. The blood uric acid (BUA) and hepatorenal function were compared in the treat- ment period, and the incidence of adverse reactions and the recurrence of gout in post-treatment were compared. Results: At 1, 2 and 3 month after treatment, the serum level of BUN in the study group was significantly lower than that of the control group (P<0.05). The re- nal function of all patients were significantly improved compared with pre-treatment (P<0.05), but the no significant difference was found between two groups at the same time(P>0.05). The control group showed the adverse reactions with limb discomfort, drowsiness, nausea, abdominal distension, diarrhea and itch of skin, and the study group showed limb discomfort, drowsiness and abdominal distension, and one patients presenting allergic skin rash and discontinuation of allopurinol. The total incidence of adverse reactions in the study group was significantly lower than that of the control group(P<0.05). Conclusion: Febuxosta could effectively and safely decrease the blood uric acid levels and improve the renal function of patients with primary gout complicated with mild to moderate renal insufficiency.