非布司他治疗慢性肾病伴高尿酸血症的疗效和机制分析

目的 分析非布司他治疗慢性肾病伴高尿酸血症的疗效和机制。方法 回顾2015年10月-2017年10月到河南医学高等专科学校附属医院诊治的慢性肾病伴高尿酸血症的患者共108例，按照随机原则分为两组，观察组54例患者采用非布司他治疗，对照组54例患者采用别嘌醇治疗，疗程均为24周。检测两组患者治疗前后血尿酸（UA）、血肌酐（Scr）、肾小球滤过率估算值（eGFR）、血尿素氮（BUN）、血白蛋白（Alb）和尿微量蛋白尿（u-mAlb）水平，比较两组患者疗效，记录肝功能受损、皮疹、胃肠道反应和血脂升高等不良反应发生情况。结果 治疗前两组患者各项指标无明显差异；治疗后UA、Scr、BUN、u-mAlb、eGFR均较治疗前明显降低，Alb较治疗前明显升高，同组治疗前后比较差异有统计学意义（P<0.05）；且治疗后观察组患者UA、Scr、BUN和u-mAlb明显低于对照组，eGFR和Alb明显高于对照组，差异均有统计学意义（P<0.05）。观察组患者高尿酸血症治疗总有效率为77.78%，明显高于对照组患者的55.56%，差异有统计学意义（P<0.05）；观察组患者肾功能治疗总有效率为83.33%，明显高于对照组患者的62.96%，差异有统计学意义（P<0.05）。观察组肝功能受损、皮疹、胃肠道反应和血脂升高等不良反应发生率明显低于对照组，差异有统计学意义（P<0.05）。结论 非布司他治疗慢性肾病伴高尿酸血症疗效确切，能够有效降低血尿酸水平，保护患者肾功能，不良反应发生率低，建议临床推广应用。

Efficacy and mechanism of febuxostat in treatment of chronic kidney disease accompanied with hyperuricemia

Objective To analyze the efficacy and mechanism of febuxostat in treatment of chronic kidney disease accompanied with hyperuricemia.Methods A total of 108 patients diagnosed with chronic kidney disease accompanied with hyperuricemia in our hospital from October 2015 to October 2017 were involved in this research.They were randomly divided into two groups.54 patients in observation group were treated with febuxostat,and 54 patients in control group were treated with allopurinol.Efficacy was compared in two groups.Results Indexes in two groups before treatment showed no obvious difference.After treatment,levels of blood uric acid,serum creatinine,blood urea nitrogen and urinary microalbuminuria in observation group were significantly lower than those in control group,and estimated value of glomerular filtration rate and blood albumin were obviously higher compared to control group (P< 0.05).Total effective rates of hyperuricemia and renal function in observation group were significantly higher than those in control group,and adverse reaction incidence of liver function damage,erythra,gastrointestinal reaction and blood lipid increase was obviously lower compared to control group (P< 0.05).Conclusion The efficacy of febuxostat in treatment of chronic kidney disease accompanied with hyperuricemia is remarkable,which can effectively reduce blood uric acid level,protect renal function of patients and lower adverse reaction incidence,and recommend clinical popularization and application.