内科

目的对比分析非布司他与别嘌醇治疗慢性肾脏病（CKD）合并高尿酸血症患者的临床效果及安全性。方法选择2018年2月至2020年6月我院收治的CKD合并高尿酸血症患者90例为观察对象，采用随机数字法分为非布司他组和别嘌醇组，每组45例。在接受常规治疗的基础上，别嘌醇组患者服用别嘌醇片治疗，非布司他组服用非布司他治疗，疗程6个月。比较两组患者的临床疗效；检测比较两组患者治疗前后的血尿酸（SUA）及炎症因子水平；比较两组患者治疗期间的不良反应发生情况。结果治疗6个月，非布司他组患者的治疗总有效率（93.33%）显著高于别嘌醇组（73.33%），差异有统计学意义（P＜0.05）。治疗前，两组患者的SUA、肿瘤坏死因子-α（TNF-α）、白细胞介素-6（IL-6）、转化生长因子-β1（TGF-β1）水平比较，差异无统计学意义（P＞0.05）；治疗6个月后，两组患者的SUA、TNF-α、IL-6、TGF-β1水平均明显下降，非布司他组患者的水平均显著低于别嘌醇组，差异有统计学意义（P＜0.05）。治疗期间，非布司他组患者的不良反应发生率（6.67%）明显低于别嘌醇组（24.44%），差异有统计学意义（P＜0.05）。结论非布司他治疗慢性肾脏病合并高尿酸血症患者的临床效果明显优于别嘌醇治疗，可更有效地降低患者的尿酸及炎症因子水平，降低不良反应的发生率。

ObjectiveTo compare the clinical effect and therapeutic safety of febuxostat and allopurinol in treating chronic kidney disease (CKD) patients complicated with hyperuricemia. MethodsFrom February 2018 to June 2020, 90 patients with CKD complicated with hyperuricemia admitted to our hospital were selected as the observation objects and divided into febuxostat group and allopurinol group by the random number method, with 45 cases in each group. On the basis of conventional treatment, patients in the allopurinol group were treated with allopurinol tablets and the febuxostat group was treated with febuxostat for 6 months. The clinical efficacy of the two groups was compared. The levels of serum uric acid (SUA) and inflammatory factors were examined and compared between the two groups before and after treatment. And the occurrence of adverse reactions during treatment was compared between the two groups. ResultsAfter 6 months of treatment, the total effective rate in the febuxostat group (93.33%) was significantly higher than that in the allopurinol group (73.33%), the difference was statistically siginificant (P＜0.05). Before treatment, there were no statistically significant differences in the levels of SUA, tumor necrosis factor-α (TNF-α), interleukin-6 (IL-6) and tranforming growth factor-β1 (TGF-β1) between the two groups (P＞0.05). After 6 months of treatment, the levels of SUA, TNF-α, IL-6 and TGF-β1 in both groups significantly decreased, and those in the febuxostat group were significantly lower than those in the allopurinol group, which differences were statistically significant (P＜0.05). During the treatment, the occurrence of adverse reactions in the febuxostat group was 6.67%, which was significantly lower than that in the allopurinol group (24.44%), with a statistical significant difference (P＜0.05). ConclusionThe clinical effect of febuxostat for treating CKD patients complicated with hyperuricemia is significantly better than that of allopurinol treatment, which can more effectively reduce the levels of SUA and inflammatory factor in patients, and decrease the occurring rate of adverse reactions.