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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
作者:刘颖  马龙新 
单位:盐城市第一人民医院 风湿免疫科, 江苏 盐城 224005
关键词:非布司他 痛风 尿酸 可溶性细胞间黏附分子-1 肿瘤坏死因子-α 
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.

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