非布司他治疗痛风的临床疗效及其对患者生活质量和血尿酸、sICAM-1、TNF-α水平的影响-现代医学

非布司他治疗痛风的临床疗效及其对患者生活质量和血尿酸、sICAM-1、TNF-α水平的影响

单位：盐城市第一人民医院风湿免疫科, 江苏盐城 224005

分类号：R589.7

出版年·卷·期（页码）：2019·38·第十一期（1310-1314）

摘要：

目的：探讨非布司他治疗痛风的临床疗效及其对患者生活质量和血尿酸（uric acid，UA）、可溶性细胞间黏附分子（solubleintercellular adhesion molecule，sICAM）-1、肿瘤坏死因子（tumor necrosis factor，TNF）-α水平的影响。方法：选取2015年2月至2018年1月本院风湿免疫科收治的113例痛风患者，行前瞻性列队研究，双盲法随机分为非布司他组和别嘌呤醇组。非布司他组57例，使用非布司他40 mg·d^-1；别嘌呤醇组56例，使用别嘌呤醇片200 mg·d^-1。两组持续用药24周，观察临床疗效，监测用药前，用药12、24周血尿酸、sICAM-1、TNF-α指标，参考类风湿关节炎患者生命质量量表评价用药前、用药24周患者的生活质量。结果：非布司他组用药12、24周sICAM-1、TNF-α、UA水平明显低于别嘌呤醇组（P<0.05）。非布司他组临床疗效显著优于别嘌呤醇组（P<0.05）；不良反应发生率明显低于别嘌呤醇组（P<0.05）。两组用药24周后，生活质量明显改善，与用药前比较差异有统计学意义（P<0.05）；非布司他组生理功能、心理功能、社会功能、健康自我认知及总分明显高于别嘌呤醇组（P<0.05）。结论：痛风患者采用非布司他治疗效果良好，可调节血尿酸、sICAM-1、TNF-α水平，减轻炎症反应，改善生活质量。

Objective: To investigate the clinical efficacy of febrix in the treatment of gout and its effect on the quality of life and the levels of uric acid (UA), soluble intercellular adhesion molecule (sICAM1)-1 and tumor necrosis factor (TNF)-α in patients with gout. Methods: 113 patients with gout were selected from the Department of Rheumatology and Immunology in our hospital from February 2015 to January 2018. A prospective queue study was carried out. 57 cases were randomly divided into two groups by double blind method. 57 cases in febuxostat group were given 40 mg·d^-1 febuxostat. 56 patients in allopurine group were treated with allopurine 200 mg·d^-1, for 24 weeks. The clinical efficacy was observed. The indexes of serum uric acid and sICAM-1, TNF-α were monitored before treatment, 12 weeks and 24 weeks after treatment. The quality of life (QOL) of rheumatoid arthritis patients was evaluated by referring to the quality of life scale (QOL). Results: The levels of sICAM-1, TNF-α, UA in the febuxostat group were significantly lower than those in the allopurinol group 12 weeks and 24 weeks after treatment (P<0.05). The clinical efficacy of the febuxostat group was significantly higher than that of the allopurinol group (P<0.05), and the incidence of adverse reactions was significantly lower in the febuxostat group than that in the allopurinol group (P<0.05). 24 weeks after treatment, the quality of life of the two groups was significantly improved (P<0.05), and the physiological function, psychological function, social function, health self-cognition and total score of the febuxostat group were significantly higher than those of the allopurinol group (P<0.05). Conclusion: The use of febuxostat in patients with gout has a good effect on regulating serum UA, sICAM-1 and TNF-α, reducing inflammatory reaction and improving quality of life.

参考文献：

[1] 唐江平,陶金辉,蒯越,等.普通人群的痛风认知现状及误区分析[J].中华疾病控制杂志,2016(6):637-639.
[2] 符婷,尹如兰,李立人,等.痛风患者生活质量评价的研究进展[J].东南大学学报(医学版),2017,36(4):645-650.
[3] DESAI J,STEIGER S,ANDERS H J.Molecular pathophysiology of gout[J].Trends Mol Med,2017,23(8):756.
[4] 于飞,叶丛,凃巍,等.影响痛风患者降尿酸治疗疗效的因素分析[J].中华风湿病学杂志,2017,21(2):110-113.
[5] 严婷婷,沈洁,史向辉,等.非布司他与别嘌醇治疗痛风伴肾功能不全患者疗效观察[J].中国药物与临床,2017,17(5):695-697.
[6] 中华医学会风湿病学分会.原发性痛风诊断和治疗指南[J].中华风湿病学杂志,2011,15(6):410-413.
[7] 陈铭扬,梁维,吕昭萍,等.类风湿关节炎患者生命质量/患者报告结局影响因素分析:QLICD-RA的应用[J].中华疾病控制杂志,2016,20(4):383-386,391.
[8] 李强,于萍.痛风的诊断与治疗[J].国际内分泌代谢杂志,2011,31(5):289-291.
[9] ZHANG T,POPE J E.Cardiovascular effects of urate-lowering therapies in patients with chronic gout:a systematic review and meta-analysis[J].Rheumatology,2017,56(7):1144-1153.
[10] ENGEL B,JUST J,BLECKWENN M,et al.Treatment options for gout[J].Dtsch Arztebl Int,2017,114(13):215-222.
[11] 张鸽,黄炜,李素丽,等.白细胞介素-37在类风湿性关节炎患者血清表达水平的研究[J].国际免疫学杂志,2017,40(4):375-378.
[12] 宋哲,路占忠,李振彬.四妙勇安方水提物对大鼠急性痛风性关节炎的治疗作用及其对外周血IL-1β、TNF-α和MIF水平的影响[J].解放军医药杂志,2016,28(5):20-23.
[13] 贺钰梅,韩秀平,汪丽丽,等.痛风性关节炎患者血清Dickkopf-1含量与骨破坏、炎症及氧化反应的相关性研究[J].海南医学院学报,2017,23(17):2357-2360.
[14] 杨虹,杨小红,钟晓武,等.辅助性T细胞17/调节性T细胞平衡在原发性痛风性关节炎发病机制中的作用[J].中华风湿病学杂志,2016,20(8):520-525.
[15] 张文,解为慈,徐金娥,等.非布司他对痛风合并高尿酸血症患者血清sICAM-1,ET-1及尿酸水平的影响[J].现代生物医学进展,2016,16(27):5303-5305.
[16] RUOFF G,EDWARDS N L.Overview of serum uric acid treatment targets in gout:why less than 6 mg/dL?[J].Postgrad Med,2016,128(7):706-715.
[17] YU K H,LAI J H,HSU P N,et al.Safety and efficacy of oral febuxostat for treatment of HLA-B^*5801-negative gout:a randomized,open-label,multicentre,allopurinol-controlled study[J].Scand J Rheumatol,2016,45(4):304-311.
[18] 徐萍,叶青,袁良俊.非布司他片、痛风定胶囊联合治疗长期高尿酸血症30例临床观察[J].医学临床研究,2016,33(3):461-464.
[19] 黄金沐,池慧琼,林少凯.比较非布司他片与别嘌呤醇片治疗高尿酸血症伴痛风的临床研究[J].中国临床药理学杂志,2017,33(20):2009-2012.
[20] 周乔,苏江,吴晓丹,等.非布司他与别嘌醇在降尿酸治疗中的有效性和安全性对比研究[J].实用医院临床杂志,2016,13(6):68-70.

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