目的 觀察非布司他片治療慢性腎衰竭非透析患者高尿酸血癥的臨床療效。方法 選擇2014年1月—2015年6月在濰坊市中醫(yī)院腎內(nèi)科的60例并發(fā)高尿酸血癥的慢性腎功能衰竭的住院患者,隨機(jī)分成對(duì)照組和治療組,每組各30例。所有患者均給予低鹽、低蛋白、低嘌呤飲食,并給予慢性腎功能不全的常規(guī)治療。對(duì)照組口服別嘌醇片100 mg,3次/d;治療組口服非布司他片40 mg,1次/d。兩組均連續(xù)治療12周。觀察兩組的臨床療效,并在治療前及治療后第1、2、4、6、8、10、12周檢查生化指標(biāo)血尿酸(SUA)、血肌酐(Scr)、血尿素氮(BUN)、丙氨酸氨基轉(zhuǎn)移酶(ALT)、天冬氨酸氨基轉(zhuǎn)移酶(AST)、血漿白蛋白(ALB)、膽固醇(TC)、三酰甘油(TG)、高密度脂蛋白(HDL-C)、低密度脂蛋白(LDL-C)及血常規(guī)相關(guān)指標(biāo)白細(xì)胞(WBC)計(jì)數(shù)、血紅蛋白(HB)。結(jié)果 治療后,對(duì)照組總有效率為80.00%,治療組總有效率為96.67%,兩組總有效率比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。治療后,兩組患者SUA、Scr、BUN水平均顯著降低,同組治療前后差異具有統(tǒng)計(jì)學(xué)意義(P<0.05);且治療組這些觀察指標(biāo)的下降程度優(yōu)于對(duì)照組,兩組比較差異具有統(tǒng)計(jì)學(xué)意義(P<0.05)。兩組患者治療前后ALT、AST、ALB、TG、TC、HDL-C、LDL-C、WBC、HB均無(wú)明顯改變,差異無(wú)統(tǒng)計(jì)學(xué)意義。結(jié)論 非布司他片較別嘌醇片更能有效地降低慢性腎功能衰竭非透析患者的SUA水平,起效快,效果肯定,且無(wú)明顯不良反應(yīng),具有一定的臨床推廣應(yīng)用價(jià)值。

Objective To observe the effect of Febuxostat Tablets in treatment of hyperuricemia in patients with chronic renal failure and non dialysis. Methods Patients (60 cases) with chronic renal failure and non dialysis in Department of Urology of Weifang Traditional Chinese Hospital from January 2014 to June 2015 were randomly divided into control and treatment groups, and each group had 30 cases. All patients were given low salt, low protein, and low purine diet, and given the conventional treatment of chronic renal insufficiency. The patients in the control group were po administered with Allopurinol Tablets, 100 mg/time, three times daily. The patients in the treatment group were po administered with Febuxostat Tablets, 40 mg/time, once daily. The patients in two groups were treated for 12 weeks. After treatment, the clinical efficacies were evaluated. Biochemical indexes, such as serum uric acid (SUA), serum creatinine (Scr), blood urea nitrogen (BUN), alanine aminotransferase (ALT), aspartic acid amino shift enzyme (AST), albumin (ALB), total cholesterol (TC), triglyceride (TG), high density lipoprotein (HDL-C), and low density lipoprotein cholesterol (LDL-C), and routine blood test biochemical indicators, such as white blood cell (WBC) count and hemoglobin (HB) were determined before treatment and 1, 2, 4, 6, 8, 10, and 12 weeks after treatment. Results After treatment, the clinical efficacies in the control and treatment groups were 80.00% and 96.67%, respectively, and there were differences between two groups (P< 0.05). After treatment, the levels of SUA, Scr, and BUN in two groups were significantly decreased, and the difference was statistically significant in the same group (P< 0.05). And these indicators in the treatment group were lower than those in the control group, with significant difference between two groups (P< 0.05). After treatment, the levels of ALT, AST, ALB, TG, TC, HDL-C, LDL-C, WBC, and HB had no differences in the same group. Conclusion Compared with Allopurinol Tablets, Febuxostat Tablets has better clinical effect in treatment of hyperuricemia in patients with chronic renal failure and non dialysis, which can effectively reduce the levels of SUA, has rapid effect and define effect with little adverse reaction, and which has a certain clinical application value.