| 刘岩,李斯琪,刘兵,黄带发,刘艳霞.非布司他与别嘌醇治疗高龄高尿酸血症患者的效果和安全性[J].中国临床保健杂志,2020,23(5):607-611. |
| 非布司他与别嘌醇治疗高龄高尿酸血症患者的效果和安全性 |
| Comparative study on the efficacy and safety of febuxostat and allopurinol in the treatment of elderly patients with hyperuricemia |
| 投稿时间：2019-12-27 |
| DOI：10.3969/J.issn.1672-6790.2020.05.008 |
| 中文关键词: 高尿酸血症 别嘌呤醇 抗痛风药 药物相关性副作用和不良反应 老年人,80以上 |
| 英文关键词: Hyperuricemia Allopurinol Gout suppressants Drug-related side effects and adverse reactions Aged,80 and over 〖FL |
| 基金项目:国家自然科学基金面上项目(81670267)；中国博士后科学基金面项目一等资助(2018M633697)；辽宁省自然科学基金指导计划项目(20180550534)；辽宁省自然科学基金指导计划项目(2019ZD1042) |
| 作者 | 单位 | E-mail | | 刘岩 | 国家老年疾病临床研究中心,北部战区总医院老年医学中心干二科,沈阳 110016 | 33347049@qq.com | | 李斯琪 | 国家老年疾病临床研究中心,北部战区总医院老年医学中心干二科,沈阳 110016 | | | 刘兵 | 国家老年疾病临床研究中心,北部战区总医院老年医学中心干二科,沈阳 110016 | | | 黄带发 | 国家老年疾病临床研究中心,北部战区总医院老年医学中心干二科,沈阳 110016 | | | 刘艳霞 | 国家老年疾病临床研究中心,北部战区总医院老年医学中心干二科,沈阳 110016 | lyxzp7029@sina.com |
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| 中文摘要: |
| 目的 对比非布司他和别嘌醇治疗高龄高尿酸血症患者的临床疗效及不良反应。方法 选取年龄≥80岁的高尿酸血症患者200例行HLA-B5801基因检测,去除不适合别嘌醇治疗者。按照随机数字表法分为非布司他组(103例)和别嘌醇组(97例)。非布司他组:口服非布司他40 mg,1次/日,2周后血尿酸未达标(≥360 μmol/L)者,调整为80 mg,1次/日；别嘌醇组:口服别嘌醇50 mg,2次/日,2周后血尿酸未达标(≥360 μmol/L)者,调整为100 mg,2次/日。用药前及用药后2、4、8、12、24周抽取患者清晨空腹静脉血,检测血尿酸水平和血生化指标,计算患者尿酸达标率并记录用药期间的不良反应。结果 治疗2、4、8、12、24周后非布司他组患者的血尿酸达标率为分别为59.22%(61例)、65.05%(67例)、69.90%(72例),72.82%(75例)和74.76%(77例),未达标者血尿酸水平也明显下降。别嘌醇组各时间点血尿酸达标率分别为40.21%(39例)、45.36%(45例)、51.55%(50例) 、57.73%(56例)和 59.79%(58例)。用药2、4、8、12、24周两组血尿酸达标率持续升高(用药8周后两组药物均未加量),非布司他组血尿酸达标率显著高于别嘌醇组,差异有统计学意义(P<0.05)。在24周观察期间非布司他组患者不良反应发生率5.83%(痛风发作1例,轻度肝功异常3例,腹痛2例)；别嘌醇组不良反应发生率6.19%(皮疹2例,轻度肝功异常2例,腹泻2例),差异无统计学意义(P>0.05)。两组患者在观察期间均未发生严重心血管事件等严重不良反应。结论 非布司他治疗高龄患者高尿酸血症早期(2周)达标率明显高于别嘌醇,而且用药前无需进行HLA-B5801基因检测。 |
| 英文摘要: |
| Objective To compare the clinical efficacy and adverse reactions of febuxostat and allopurinol in the treatment of elderly patients with hyperuricemia.Methods A total of 200 patients with hyperuricemia aged 80 years or older were selected.HLA-B5801 gene testing was performed to remove those who were not suitable for allopurinol treatment.They were randomly divided into febuxostat group(103 cases)and allopurinol group (97 cases).Febuxostat group:oral febuostat 40 mg/d,2 weeks later if the blood uric acid did not meet the standard (≥360 μmol/L),the oral febuxostat will be adjusted to 80 mg/d.Allopurinol group:oral allopurinol 100 mg/d,2 weeks later if the blood uric acid did not meet the standard (≥360μmol/L),the oral allopurinol will be adjusted to 200 mg/d.Fasting venous blood samples were collected at 2,4,8,12,24 weeks after treatment.Blood uric acid levels and biochemical indicators were measured.The uric acid control rate was calculated and adverse reactions were recorded during the medication period.Results After 2,4,8,12 and 24 weeks of treatment,the serum uric acid control rates of patients in the febutastat group were 59.22% (61 cases),65.05% (67 cases),69.90% (72 cases),72.82% (75 cases) and 74.76%(77 cases).In the allopurinol group,the uric acid control rates at each time point were 40.21% (39 cases),45.36% (45 cases),51.55% (50 cases),57.73% (56 cases),and 59.79% (58 cases).Serum uric acid control rates continued to increase in the two groups after 2,4,8,12,and 24 weeks of treatment (both drugs were not added in both groups after 8 weeks of medication).The control rate with serum uric acid in the febuxostat group was significantly higher than that in the allopurinol group (P<0.05).During the observation period,the incidence of adverse reactions was 5.83% (1 case of gout attack,3 cases of mild liver dysfunction and 2 cases of abdominal pain) in the febuxostat group and 6.19% (2 cases of mild skin rash,2 cases of mild liver dysfunction and 2 cases of diarrhea) in the allopurinol group,the difference was not statistically significant (P>0.05).During the observation period,no serious adverse reactions such as serious cardiovascular events occurred in both groups.Conclusion The control rate with febuxostat in elderly patients with hyperuricemia in the early stage (2 weeks) is higher than that of allopurinol,without HLA-B5801 gene testing before treatment. |
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