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目的探讨非布司他治疗痛风伴高尿酸血症的临床疗效。方法选取佛山市第一人民医院特需医疗中心2015年1月—2017年1月收治的痛风伴高尿酸症患者78例,按照随机法将患者分甲组、乙组、丙组,各26例。甲组患者采用40 mg/d的非布司他治疗;乙组采用80mg/d的非布司他治疗;丙组采用别嘌醇治疗,3组均治疗20周。比较3组患者血尿酸水平、肝肾功能[丙氨酸氨基转移酶(ALT)、天冬氨酸氨基转移酶(AST)、尿素氮(BUN)、肌酐(Cr)]及不良反应发生情况。结果治疗前,3组患者血尿酸水平比较,差异无统计学意义(P>0.05)。治疗8周、20周后,3组患者血尿酸水平比较,差异有统计学意义(P<0.05);治疗8周、20周后,乙组和丙组患者血尿酸水平低于甲组,3组患者血尿酸水平低于治疗前(P<0.05)。治疗前后,3组患者ALT、AST、BUN及Cr水平比较,差异无统计学意义(P>0.05)。3组患者不良反应发生率比较,差异有统计学意义(P<0.05),其中乙组和丙组不良反应发生率低于甲组(P<0.05)。乙组和丙组不良反应发生率比较,差异无统计学意义(P>0.05)。结论采用别嘌醇和非布司他治疗痛风伴高尿酸血症均可降低患者血尿酸水平,但非布司他耐受性更好,且80 mg/d的非布司他临床疗效优于40 mg/d。
Objective To investigate the clinical efficacy of febuxostat in treating gout with hyperuricemia. Methods Totally 78 patients with gout and hyperuricaemia were admitted to Special Medical Center of Foshan First People’s Hospital from January 2015 to January 2017. According to randomized method, patients were divided into group A, group B and group C, with 26 cases in each group. Patients in group A were treated with 40 mg / d febuxostat; group B was treated with febuxostat at 80 mg / d; group C was treated with allopurinol and group 20 were treated for 20 weeks. The levels of serum uric acid, hepatic and renal functions (ALT, AST, BUN, creatinine) and incidence of adverse reactions in the three groups were compared. Results Before treatment, there was no significant difference in serum uric acid between the three groups (P> 0.05). After 8 and 20 weeks of treatment, the levels of serum uric acid in the three groups were significantly different (P <0.05). After 8 and 20 weeks of treatment, the level of serum uric acid in group B and group C was lower than that in group A and group 3 The level of serum uric acid in patients was lower than that before treatment (P <0.05). Before and after treatment, there was no significant difference in ALT, AST, BUN and Cr between the three groups (P> 0.05). The incidence of adverse reactions in the three groups was statistically significant (P <0.05). The incidence of adverse reactions in groups B and C was lower than that in group A (P <0.05). There was no significant difference in the incidence of adverse reactions between group B and group C (P> 0.05). Conclusions Both allopurinol and febuxostat can reduce blood uric acid in patients with gout and hyperuricemia, but febuxostat is better tolerated, and the clinical efficacy of febuxostat 80 mg / d is better than 40 mg / d.