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非布司他治疗2型糖尿病肾病合并高尿酸血症的临床观察
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| 篇名： | 非布司他治疗2型糖尿病肾病合并高尿酸血症的临床观察 |
| TITLE： | |
| 摘要： | 目的：观察非布司他治疗2型糖尿病肾病（DN）合并高尿酸血症的临床疗效及安全性。方法：选择2014年1月－2016年6月我院收治的2型DN合并高尿酸血症患者137例，按随机数字表法分为A组（46例）、B组（47例）、C组（44例）。在常规治疗方案的基础上，A组患者口服别嘌醇片，起始剂量0.05 g，bid；2周后增至0.10 g，bid。B组患者口服苯溴马隆片50 mg，qd。C组患者口服非布司他片，起始剂量40 mg，qd；2周后增至80 mg，qd。所有患者均连续治疗12周。观察两组患者的临床疗效以及治疗前后血尿酸（SUA）、血肌酐（Scr）、血尿素氮（BUN）水平，并记录不良反应发生情况。结果：A、B、C组各有4、6、3例患者脱落。B、C组患者的总有效率（87.8％、85.4％）显著高于A组（76.2％），差异均有统计学意义（P＜0.05）；而B、C组比较差异无统计学意义（P＞0.05）。治疗前，3组患者SUA、Scr、BUN水平比较，差异均无统计学意义（P＞0.05）。治疗后4周，3组患者SUA水平均较治疗前显著降低，差异均有统计学意义（P＜0.05）；但其余指标组间及治疗前后比较，差异均无统计学意义（P＞0.05）。治疗后12周，3组患者SUA水平均较治疗前和治疗后4周显著降低，且B、C组显著低于A组；A、C组患者Scr水平均较治疗前显著降低，B组较治疗前显著升高，且B组显著高于A、C组，差异均有统计学意义（P＜0.05）；但3组患者Scr、BUN水平与治疗后4周比较，B、C组SUA水平比较，A、C组Scr水平比较，差异均无统计学意义（P＞0.05）。C组患者的不良反应总发生率（12.20％）显著低于A、B组（25.58％、24.39％），差异均有统计学意义（P＜0.05）；而A、B组比较差异无统计学意义（P＞0.05）。结论：非布司他降低2型DN合并高尿酸血症患者SUA水平的效果优于别嘌醇，且对肾功能的影响小，安全性更高。 |
| ABSTRACT： | OBJECTIVE： To observe clinical efficacy and safety of febuxostat in the treatment of type 2 diabetic nephropathy complicated with hyperuricemia. METHODS： A total of 137 patients with type 2 diabetic nephropathy complicated with hyperuricemia selected from our hospital during Jan. 2014-Jun. 2016 were divided into group A （46 cases）， B （47 cases）， C （44 cases） according to random number table. On the basis of routine treatment， group A was given Allopurinol tablets orally with initial dose of 0.05 g， bid； increasing to 0.10 g， bid， 2 weeks later. Group B was given Benzbromarone tablets 50 mg orally， qd. Group C was given Febuxostat tablets orally with initial dose of 40 mg， qd； increasing to 80 mg， qd， 2 weeks later. All patients received treatment for consecutive 12 weeks. Clinical efficacies of 2 groups were observed， and the levels of serum uric acid （SUA）， Scr and BUN were also observed before and after treatment. The occurrence of ADR was recorded. RESULTS： Four， six， three patients withdrew from the study in group A， B， C， respectively. The total response rates of group B， C （87.8％， 85.4％） were significantly higher than that of group A （76.2％）， with statistical significance （P＜0.05）； there was no statistical significance between group B and C （P＞0.05）. Before treatment， there was no statistical significance in the levels of SUA， Scr or BUN among 3 groups （P＞0.05）. Four weeks after treatment， the levels of SUA in 3 groups were decreased significantly compared to before treatment， with statistical significance （P＜0.05）； there was no statistical significance in other indexes among 3 groups or between before and after treatment （P＞0.05）. Twelve weeks after treatment， the levels of SUA in 3 groups were decreased significantly compared to before treatment and 4 weeks after treatment， and group B and C were significantly lower than group A； the levels of Scr in group A and C were decreased significantly compared to before treatment， while that of group B was increased significantly compared to before treatment and group B was significantly higher than group A and C， with statistical significance （P＜0.05）. There was no statistical significance in the levels of Scr or BUN among 3 groups compared to 4 weeks after treatment； there was also no statistical significance in the levels of SUA between group B and C， the levels of Scr between group A and C （P＞0.05）. Total incidence of ADR in group C （12.20％） was significantly lower than group A and B （25.58％， 24.39％）， with statistical significance （P＜0.05）； there was no statistical significance between group A and B （P＞0.05）. CONCLUSIONS： Febuxostat is better than allopurinol in reducing the level of SUA in type 2 diabetic nephropathy patients with hyperuricemia. It shows small effect on renal function with better safety. |
| 期刊： | 2018年第29卷第4期 |
| 作者： | 张春林，王小翠，王慧，童强，张瑞 |
| AUTHORS： | ZHANG Chunlin，WANG Xiaocui，WANG Hui，TONG Qiang，ZHANG Rui |
| 关键字： | 非布司他；别嘌醇；苯溴马隆；2型糖尿病肾病；高尿酸血症；临床疗效；血尿酸；血肌酐；血尿素氮 |
| KEYWORDS： | Febuxostat； Allopurinol； Benzbromarone； Type 2 diabetic nephropathy； Hyperuricemia； Clinical efficacy； Serum uric acid； Scr； BUN |
| 阅读数： | 456 次 |
| 本月下载数： | 6 次 |
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