苯溴马隆与非布司他在治疗2型糖尿病伴高尿酸血症的获益及安全性

目的评价苯溴马隆与非布司他在治疗2型糖尿病伴高尿酸血症的获益及安全性。方法将85例已确诊的2型糖尿病伴尿酸升高的患者随机分为苯溴马隆组(A组,44例)和非布司他组(B组,41例)。两组均给予饮食控制、口服降糖药和(或)胰岛素治疗,A组给予苯溴马隆50 mg/d口服,B组给予非布司他40 mg/d口服,疗程为3个月。结果与苯溴马隆比较,非布司他能够更快、更有效地降低血尿酸水平(P<0.05),但最终达标率比较差异无统计学意义(P>0.05)。两组均出现不同程度的不良反应,B组痛风发作率较高,而A组发生其他不良反应较多。治疗后两组患者Hb A1c均改善(P<0.05),两组比较差异无统计学意义(P>0.05)。治疗前、后两组空腹C肽水平比较差异无统计学意义(P>0.05)。治疗3个月后,A组患者120分C肽水平得到改善(P<0.05),但非布司他组未见明显改善(P>0.05)。结论在2型糖尿病合并高尿酸血症的患者中,应用非布司他及苯溴马隆治疗均能有效降低血尿酸水平,改善患者血糖。苯溴马隆能改善餐后C肽水平。

Benefit and safety of benzbromarone and febuxostat in the treatment of type 2 diabetes with hyperuricemia

Objective To evaluate the benefit and safety of benzbromarone and febuxostat in the treatment of type 2 diabetes with hyperuricemia.Methods Totally 85 patients who had been diagnosed with type 2 diabetes with hyperuricemia were divided into benzbromarone group (group A,n=44) and febuxostat group (group B,n=41).Both groups received diet control,oral hypoglycemic agents and (or) insulin therapy.Patients in group A took benzbromarone (50 mg/d) orally,and the patients in group B took febuxostat (40 mg/d) orally for 3 months.Results Compared with benzbromarone,febuxosta could reduce the uric acid levels more quickly and effectively (P<0.05),but there was no significant difference in the eventual success rates between the two groups (P>0.05).Both groups had adverse reactions,group B had higher rate of gout,while group A had higher rate of other adverse reactions.After treatments,the HbA1c in both groups was improved (P<0.05),and there was no significant difference between the two groups (P>0.05).There was no significant difference in fasting C-peptide levels between the two groups before and after treatment (P>0.05).The 120-min C-peptide levels was improved in group A at 3 months after treatment (P<0.05),but there was no significant difference in group B (P>0.05).Conclusion Both febuxostat and benzbromarone can effectively reduce the blood uric acid level of the patients of type 2 diabetes with hyperuricemia,and improve the blood glucose level.Benzbromarone can improve the postprandial C-peptide levels.