来源：风湿病与关节炎,2019,8（9）:25-27.

非布司他治疗慢性肾脏病4～5期合并痛风伴高尿酸血症15例临床观察（临床研究）

陈运转，段喜梅

　　【摘　要】目的：观察非布司他片治疗慢性肾脏病4～5期合并痛风伴高尿酸血症患者的临床疗效及安全性。方法：将28例慢性肾脏病4～5期合并痛风伴高尿酸血症患者随机分为治疗组15例和对照组13例。对照组给予严格的优质低蛋白饮食、低嘌呤饮食及慢性肾脏病4～5期常规治疗方案；治疗组在对照组治疗基础上给予口服非布司他每日20 mg。2组均以4周为1个疗程。观察2组治疗前后血尿酸、血肌酐及血尿素氮水平，计算肾小球滤过率变化，同时观察药物不良反应。结果：治疗后，治疗组血尿酸、血肌酐及血尿素氮水平较治疗前明显下降，肾小球滤过率较治疗前升高，差异均有统计学意义（P < 0.01）。对照组血尿酸、血肌酐、尿素氮及肾小球滤过率较治疗前无明显变化，差异无统计学意义（P > 0.05）。2组间比较，差异有统计学意义（P < 0.05）。治疗期间，所有患者无痛风发作，治疗组4例出现反酸症状，其余患者均未出现肝功能异常及白细胞计数下降等不良反应。结论：慢性肾脏病4～5期合并痛风伴高尿酸血症患者接受非布司他治疗，短期内可降低血尿酸，且能够延缓肾脏病进展，同时无严重不良事件发生。

　　【关键词】　慢性肾脏病；痛风；高尿酸血症；非布司他

Clinical Observation on 15 Cases of Chronic Kidney Disease of Stage 4～5 Complicated with Gout and Hyperuricemia Treated with Febuxostat

CHEN Yun-zhuan,DUAN Xi-mei

　　【ABSTRACT】Objective:To observe the clinical efficacy and safety of Febuxostat in the treatment of chronic kidney disease of stage 4～5 complicated with gout and hyperuricemia.Methods:Twenty-eight cases of chronic kidney disease of stage 4～5 complicated with gout and hyperuricemia were randomly divided into a treatment group（15 cases）and a control group（13 cases）.The control group was strictly required high-quality,low-protein and low-purine diet and given routine treatment.The treatment group was given febuxostat（20 mg·d^-1）on the basis of the treatment for the control group.Two groups were treated for 4 weeks as a course of treatment.The levels of serum uric acid,creatinine and urea nitrogen were observed before and after treatment,the glomerular filtration rate was calculated,and the adverse drug reactions were observed.Results:After treatment,the levels of serum uric acid,creatinine and urea nitrogen in the treatment group were significantly lower than those before treatment,and the glomerular filtration rate was higher than that before treatment,with statistical significance（P < 0.01）.There were no significant changes in serum uric acid,creatinine,urea nitrogen and glomerular filtration rate before treatment in the control group,with no statistical significance（P > 0.05）.There was a significant difference between the two groups（P < 0.05）.During the treatment,all patients had no gout attack,four patients in the treatment group had acid reflux symptoms,and the rest had no adverse reactions such as abnormal liver function and decreased white blood cell count.Conclusion:Febuxostat can lower hypouric acid and delay the progress of kidney disease without serious adverse in the treatment of patients with chronic kidney disease of stage 4～5 complicated with gout and hyperuricemia.

　　【Keywords】 chronic kidney disease;gout;hyperuricemia;Febuxostat