非布司他治疗男性高尿酸血症伴血脂异常患者的疗效观察

发布时间：2018-03-29 00:02

本文选题：非布司他　切入点：别嘌醇　出处：《广西中医药大学》2017年硕士论文

【摘要】：目的:本研究通过观察比非布司他和别嘌醇治疗男性高尿酸血症伴血脂异常患者前后相关疗效和安全性指标的变化,来评价非布司他治疗男性高尿酸血症伴血脂异常的有效性和安全性?方法:选取2015年1月至2016年6月在广西中医药大学附属瑞康医院门诊收治的同时符合诊断标准高尿酸血症伴血脂异常男性患者90例为研究对象?用随机数字表的方式把病人分为非布司他40mg组(30人)、非布司他80mg组(30人)、别嘌醇组(30人)?分别对各组病人治疗前后的血尿酸(UA)、总胆固醇(TC)、血清甘油三脂(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HCL)、C反应蛋白(CRP)、血管内皮素-1(ET-1)、肾功能(SCr)、肝功能(ALT、AST)进行检测和对比评估,并注意观察记录各组病人在治疗过程中出现的不良反应并进行比较评估?结果:1、非布司他治疗高尿酸血症伴血脂异常有效性分析:本试验入组的高尿酸血症伴血脂异常的各组患者UA、TG、TC、HDL及LDL等各项指标试验前基线水平无统计学差异(P0.05)。经过12周治疗后非布司他低剂量组、高剂量组及别嘌醇组患者血清UA水平均明显下降,与治疗前比较差异均有统计学意义(P0.05)。治疗后非布司他高剂量组与低剂量组、别嘌醇组比较血清UA水平下降更明显,且差异有统计学意义(P0.05)。非布司他高剂量组患者治疗后血清TG、TC、LDL水平均下降,与治疗前比较差异均有统计学意义(P0.05),该组患者治疗后血清HDL水平升高,与治疗前比较差异有统计学意义(P0.05)。非布司他低剂量组治疗后仅TG水平有变化,且差异有统计学意义(P0.05)。非布司他高剂量组治疗后TG水平降低幅度大于低剂量组,且差异有统计学意义(P0.05)。别嘌醇组患者治疗前后TG、TC、HDL及LDL水平差异均无统计学意义(P0.05)。2、非布司他治疗高尿酸血症伴血脂异常安全性分析:治疗后三组CRP和ET-1水平均有下降,各组与治疗前比较差异均有统计学意义(P0.05),而治疗后三组之间CRP和ET-1水平比较,差异无统计学意义(P0.05)。治疗后非布司他低剂量组和高剂量组SCr水平较别嘌醇组水平略低,且差异有统计学意义(P0.05)。治疗后别嘌醇组ALT水平高于低剂量组和高剂量组,且差异有统计学意义(P0.05)。而治疗后三组之间AST水平差异均无有统计学意义(P0.05)。非布司他高剂量组患者在治疗初期痛风发生率稍高于低剂量组及别嘌醇组,差异有统计学意义(P0.05),在治疗后期三组痛风发作率不具有差异性(P0.05)。在不良反应发生率方面,别嘌醇组略高于非布司他低剂量组和高剂量组。结论:1、非布司他可以有效降低男性高尿酸血症伴血脂异常患者的血尿酸水平并改善异常的血脂指标,同时不增加肝肾功能损害及心血管疾病风险。2、非布司他较别嘌醇有更好的降尿酸和调节血脂的作用。3、非布司他治疗高尿酸血症伴血脂异常男性患者的效果与非布司他的剂量相关。而治疗时应低剂量起始逐渐加量以减少痛风发作的风险。
[Abstract]:Objective: to observe the changes of efficacy and safety indexes before and after treatment of hyperuricemia with dyslipidemia in male patients with hyperuricemia and allopurinol. To evaluate the efficacy and safety of Festa in the treatment of hyperuricemia with dyslipidemia in men? Methods: from January 2015 to June 2016, 90 male patients with hyperuricemia and dyslipidemia who were admitted in the outpatient clinic of Ruikang Hospital affiliated to Guangxi University of traditional Chinese Medicine were selected as the study objects. Patients were randomly divided into three groups: 30 patients in 40mg group, 30 patients in 80mg group and 30 patients in allopurinol group. Serum uric acid UAA, total cholesterol TCU, serum triglyceride TGG, low density lipoprotein (LDLX), high density lipoprotein (HDL-C), HCLU C reactive protein (CRP), endothelin-1 (et 1), renal function and liver function (ALTAST) were measured and compared before and after treatment. And observe and record the adverse reactions of the patients in each group during the course of treatment and make a comparative evaluation? Results: the analysis of the effectiveness of Festa in treating hyperuricemia with dyslipidemia: there was no significant difference in baseline level before the test (P 0.05) between the patients with hyperuricemia and dyslipidemia. After 12 weeks of treatment, the low-dose group, The levels of serum UA in high dose group and allopurinol group were significantly lower than those before treatment (P 0.05). After treatment, the serum UA level in non-bufltas group and low dose group was significantly lower than that in allopurinol group, and the serum UA level in allopurinol group was significantly lower than that in control group. After treatment, the levels of serum TGN TCU LDL in the high dose group decreased, and the difference was statistically significant compared with that before treatment. The serum HDL level of the patients in the high dose group was higher than that in the control group, and there was no significant difference between the two groups before and after treatment, and there was a significant difference between them before and after treatment, and there was a significant difference between the two groups. Compared with before treatment, the difference was statistically significant (P 0.05). After treatment, the level of TG in the low dose group was changed, and the difference was statistically significant (P 0.05). The decrease of TG level in the high dose group was higher than that in the low dose group. In allopurinol group, there was no significant difference in CRP and LDL levels before and after treatment. There was no significant difference in the levels of CRP and ET-1 in patients with hyperuricemia and dyslipidemia after treatment. After treatment, there was no significant difference in the levels of CRP and ET-1 between the three groups. After treatment, the levels of SCr in the low-dose group and high-dose group were slightly lower than those in the allopurinol group. The level of ALT in allopurinol group was higher than that in low dose group and high dose group. There was no significant difference in the level of AST between the three groups after treatment. The incidence of gout in the high dose group was slightly higher than that in the low dose group and allopurinol group. The difference was statistically significant (P 0.05). There was no significant difference in gout attack rate among the three groups in the later stage of treatment. The allopurinol group was slightly higher than the low dose group and the high dose group. Conclusion: 1: 1, Festa can effectively reduce the serum uric acid level and improve the abnormal blood lipid index in the male patients with hyperuricemia and dyslipidemia. At the same time, it did not increase liver and kidney function damage and cardiovascular disease risk. The effect of non-buflast on hyperuricemia with dyslipidemia was better than allopurinol on decreasing uric acid and regulating blood lipid. Star dose-dependent. Low dose initial dose should be used gradually to reduce the risk of gout attack.
【学位授予单位】：广西中医药大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R589.7

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