本文選題：非布司他　切入點(diǎn)：別嘌醇　出處：《廣西中醫(yī)藥大學(xué)》2017年碩士論文

【摘要】：目的:本研究通過觀察比非布司他和別嘌醇治療男性高尿酸血癥伴血脂異�；颊咔昂笙嚓P(guān)療效和安全性指標(biāo)的變化,來評(píng)價(jià)非布司他治療男性高尿酸血癥伴血脂異常的有效性和安全性?方法:選取2015年1月至2016年6月在廣西中醫(yī)藥大學(xué)附屬瑞康醫(yī)院門診收治的同時(shí)符合診斷標(biāo)準(zhǔn)高尿酸血癥伴血脂異常男性患者90例為研究對(duì)象?用隨機(jī)數(shù)字表的方式把病人分為非布司他40mg組(30人)、非布司他80mg組(30人)、別嘌醇組(30人)?分別對(duì)各組病人治療前后的血尿酸(UA)、總膽固醇(TC)、血清甘油三脂(TG)、低密度脂蛋白(LDL)、高密度脂蛋白(HCL)、C反應(yīng)蛋白(CRP)、血管內(nèi)皮素-1(ET-1)、腎功能(SCr)、肝功能(ALT、AST)進(jìn)行檢測(cè)和對(duì)比評(píng)估,并注意觀察記錄各組病人在治療過程中出現(xiàn)的不良反應(yīng)并進(jìn)行比較評(píng)估?結(jié)果:1、非布司他治療高尿酸血癥伴血脂異常有效性分析:本試驗(yàn)入組的高尿酸血癥伴血脂異常的各組患者UA、TG、TC、HDL及LDL等各項(xiàng)指標(biāo)試驗(yàn)前基線水平無統(tǒng)計(jì)學(xué)差異(P0.05)。經(jīng)過12周治療后非布司他低劑量組、高劑量組及別嘌醇組患者血清UA水平均明顯下降,與治療前比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后非布司他高劑量組與低劑量組、別嘌醇組比較血清UA水平下降更明顯,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。非布司他高劑量組患者治療后血清TG、TC、LDL水平均下降,與治療前比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05),該組患者治療后血清HDL水平升高,與治療前比較差異有統(tǒng)計(jì)學(xué)意義(P0.05)。非布司他低劑量組治療后僅TG水平有變化,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。非布司他高劑量組治療后TG水平降低幅度大于低劑量組,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。別嘌醇組患者治療前后TG、TC、HDL及LDL水平差異均無統(tǒng)計(jì)學(xué)意義(P0.05)。2、非布司他治療高尿酸血癥伴血脂異常安全性分析:治療后三組CRP和ET-1水平均有下降,各組與治療前比較差異均有統(tǒng)計(jì)學(xué)意義(P0.05),而治療后三組之間CRP和ET-1水平比較,差異無統(tǒng)計(jì)學(xué)意義(P0.05)。治療后非布司他低劑量組和高劑量組SCr水平較別嘌醇組水平略低,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。治療后別嘌醇組ALT水平高于低劑量組和高劑量組,且差異有統(tǒng)計(jì)學(xué)意義(P0.05)。而治療后三組之間AST水平差異均無有統(tǒng)計(jì)學(xué)意義(P0.05)。非布司他高劑量組患者在治療初期痛風(fēng)發(fā)生率稍高于低劑量組及別嘌醇組,差異有統(tǒng)計(jì)學(xué)意義(P0.05),在治療后期三組痛風(fēng)發(fā)作率不具有差異性(P0.05)。在不良反應(yīng)發(fā)生率方面,別嘌醇組略高于非布司他低劑量組和高劑量組。結(jié)論:1、非布司他可以有效降低男性高尿酸血癥伴血脂異�；颊叩难蛩崴讲⒏纳飘惓５难笜�(biāo),同時(shí)不增加肝腎功能損害及心血管疾病風(fēng)險(xiǎn)。2、非布司他較別嘌醇有更好的降尿酸和調(diào)節(jié)血脂的作用。3、非布司他治療高尿酸血癥伴血脂異常男性患者的效果與非布司他的劑量相關(guān)。而治療時(shí)應(yīng)低劑量起始逐漸加量以減少痛風(fēng)發(fā)作的風(fēng)險(xiǎn)。
[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.
【學(xué)位授予單位】：廣西中醫(yī)藥大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類號(hào)】：R589.7

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