氯沙坦联合苯溴马隆治疗肾脏疾病并高尿酸血症临床研究
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摘要
目的探讨氯沙坦联合苯溴马隆治疗肾脏疾病并高尿酸血症的临床疗效及安全性。方法选取长江航运总医院肾内科2015年1月至2017年4月收治的肾脏疾病并高尿酸血症患者160例,按随机数字表法分为观察组、对照组、氯沙坦组和苯溴马隆组,各40例。对照组采用常规治疗,观察组加用氯沙坦联合苯溴马隆,氯沙坦组加用氯沙坦治疗,苯溴马隆组加用苯溴马隆治疗,随访6个月。结果观察组患者的血尿酸水平显著低于其余3组,血清肌酐(SCr)显著低于对照组及苯溴马隆组,血尿酸氮(BUN)显著低于其余3组,微量白蛋白尿(m Alb)显著低于其余3组(P=0. 000 <0. 05); 4组不良反应发生率比较无显著差异(P> 0. 05),观察组不良反应严重程度显著低于氯沙坦组及苯溴马隆组,但高于对照组(P <0. 05)。结论采用氯沙坦联合苯溴马隆治疗肾脏疾病并高尿酸血症可显著降低血尿酸、SCr、BUN、m Alb,同时联合治疗的不良反应严重程度低于单纯服用氯沙坦或苯溴马隆,安全性更高。
Objective To investigate the clinical efficacy and safety of losartan combined with benzbromarone in the treatment of renal diseases complicated with hyperuricemia. Methods Totally 160 patients with renal diseases complicated with hyperuricemia admitted to the Department of Nephrology in General Hospital of the Yangtze River Shipping from January 2015 to April 2017 were selected and divided into the observation group,control group,losartan group and benzbromarone group according to the random number table method,40 cases in each group. The patients in the control group were given routine treatment,on this basis,the patients in the observation group were given losartan combined with benzbromarone,the patients in the losartan group were given losartan,and the patients in the benzbromarone group were given benzbromomalone. All the patients were followed up for six months. Results The level of serum uric acid in the observation group was significantly lower than that in the other three groups,the level of serum creatinine( SCr) in the observation group was significantly lower than that in the control group and benzbromarone group,the level of blood uric acid nitrogen( BUN) in the observation group was significantly lower than that in the other three groups,and the level of microalbuminuria( m Alb) in the observation group was significantly lower than that in the other three groups( P = 0. 000 < 0. 05). There was no significant difference in the incidence of adverse reactions among the four groups( P > 0. 05). The severity of adverse reactions in the observation group was significantly lower than that in the losartan group and benzbromarone group,but which was higher than that in the control group( P < 0. 05).Conclusion Losartan combined with benzbromarone can significantly reduce the levels of serum uric acid,SCr,BUN and m Alb in patients with renal diseases complicated with hyperuricemia. The adverse reactions induced by combined treatment are lower than those induced by losartan or benzbromarone alone,and the safety was higher.
Objective To investigate the clinical efficacy and safety of losartan combined with benzbromarone in the treatment of renal diseases complicated with hyperuricemia. Methods Totally 160 patients with renal diseases complicated with hyperuricemia admitted to the Department of Nephrology in General Hospital of the Yangtze River Shipping from January 2015 to April 2017 were selected and divided into the observation group,control group,losartan group and benzbromarone group according to the random number table method,40 cases in each group. The patients in the control group were given routine treatment,on this basis,the patients in the observation group were given losartan combined with benzbromarone,the patients in the losartan group were given losartan,and the patients in the benzbromarone group were given benzbromomalone. All the patients were followed up for six months. Results The level of serum uric acid in the observation group was significantly lower than that in the other three groups,the level of serum creatinine( SCr) in the observation group was significantly lower than that in the control group and benzbromarone group,the level of blood uric acid nitrogen( BUN) in the observation group was significantly lower than that in the other three groups,and the level of microalbuminuria( m Alb) in the observation group was significantly lower than that in the other three groups( P = 0. 000 < 0. 05). There was no significant difference in the incidence of adverse reactions among the four groups( P > 0. 05). The severity of adverse reactions in the observation group was significantly lower than that in the losartan group and benzbromarone group,but which was higher than that in the control group( P < 0. 05).Conclusion Losartan combined with benzbromarone can significantly reduce the levels of serum uric acid,SCr,BUN and m Alb in patients with renal diseases complicated with hyperuricemia. The adverse reactions induced by combined treatment are lower than those induced by losartan or benzbromarone alone,and the safety was higher.
引文
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[7]常颂桔,王洪雄,黄伟.苯溴马隆对高尿酸血症老年高血压合并糖尿病患者降尿酸的临床疗效与安全性[J].昆明医科大学学报,2016,37(1):94-97.
[8]谭冰,熊毅.痛风的药物治疗研究进展[J].中国药业,2013,22(14):111-112.
[9]中国医师协会肾脏内科医师分会.中国肾脏疾病高尿酸血症诊治的实践指南(2017版)[J].中华医学杂志,2017,97(25):1927-1936.
[10] HAHN K,KANBAY M,LANASPAM A,et al. Serum uric and acute kidney injury:A mini review[J]. J Adu Res,2017,8(5):529-536.
[11] YAMASHITA M. Study on effectiveness and safety of a uricosuric agent for hyperuricemia in the patients with chronic renal failure[J]. Teikyo Medical Journal,2010,33(3):165-173.
[12]唐利群.氯沙坦钾联合黄葵胶囊治疗慢性肾小球肾炎的效果分析[J].中国医学前沿杂志:电子版,2016,8(11):64-67.
[13]胡瑞海,贾微微,黄志芳,等.苯溴马隆治疗高尿酸血症对CKD患者肾功能影响的观察[J].人民军医,2017(6):571-573.
[14] EL-NAHAS AR,ELSAADANY MM,TAHA D,et al. A randomised controlled trial evaluating renal protective effects of selenium with vitamins A,C,E,verapamil,and losartan against extracorporeal shockwave lithotripsy-induced renal injury[J]. Bju International,2016,119(1):142.
[15]田江宣,陈日秋,季晓珍,等.贝前列素钠联用氯沙坦钾对糖尿病肾病早期患者的临床研究[J].中国临床药理学杂志,2016,32(1):15-17.
[16]顾佩莉,蒋晓真,陈蕊华,等.氯沙坦钾对糖尿病肾病患者Chemerin,C反应蛋白,白细胞介素-6和尿微量白蛋白/肌酐比值的影响[J].上海医学,2016(7):413-416.
[17] STAMP LK,HASLETT J,FRAMPTON C,et al. The safety and efficacy of benzbromarone in gout in Aotearoa New Zealand[J].Internal Medicine Journal,2016,46(9):1075-1080.
[18] GLIOZZI M,MALARA N,MUSCOLI S,et al. The treatment of hyperuricemia[J]. International Journal of Cardiology,2016,213(1):23-27.
[2] MINER J,TAN PK,HYNDMAN D,et al. Lesinurad,a novel,oral compound for gout,acts to decrease serum uric acid through inhibition of urate transporters in the kidney[J]. Arthritis Research&Therapy,2016,18(1):214.
[3] VARGASSANTOS AB,NEOGI T. Management of Gout and Hyperuricemia in CKD[J]. American Journal of Kidney Diseases,2017,70(3):422.
[4] MOME R,BAKINDE N. Febuxostat for Asymptomatic Hyperuricemia in CKD[J]. American Journal of Kidney Diseases,2016,67(6):989.
[5] SRIVASTAVA A,ADAMS-HUET B,VEGA GL,et al. Effect of losartan and spironolactone on triglyceride-rich lipoproteins in diabetic nephropathy[J]. Journal of Investigative Medicine,2016,64(6):1102-1108.
[6] ANBAR HS,SHEHATOU GSG,SUDDEK GM,et al. Comparison of the effects of levocetirizine and losartan on diabetic nephropathy and vascular dysfunction in streptozotocin-induced diabetic rats[J].European Journal of Pharmacology,2016,780:82-92.
[7]常颂桔,王洪雄,黄伟.苯溴马隆对高尿酸血症老年高血压合并糖尿病患者降尿酸的临床疗效与安全性[J].昆明医科大学学报,2016,37(1):94-97.
[8]谭冰,熊毅.痛风的药物治疗研究进展[J].中国药业,2013,22(14):111-112.
[9]中国医师协会肾脏内科医师分会.中国肾脏疾病高尿酸血症诊治的实践指南(2017版)[J].中华医学杂志,2017,97(25):1927-1936.
[10] HAHN K,KANBAY M,LANASPAM A,et al. Serum uric and acute kidney injury:A mini review[J]. J Adu Res,2017,8(5):529-536.
[11] YAMASHITA M. Study on effectiveness and safety of a uricosuric agent for hyperuricemia in the patients with chronic renal failure[J]. Teikyo Medical Journal,2010,33(3):165-173.
[12]唐利群.氯沙坦钾联合黄葵胶囊治疗慢性肾小球肾炎的效果分析[J].中国医学前沿杂志:电子版,2016,8(11):64-67.
[13]胡瑞海,贾微微,黄志芳,等.苯溴马隆治疗高尿酸血症对CKD患者肾功能影响的观察[J].人民军医,2017(6):571-573.
[14] EL-NAHAS AR,ELSAADANY MM,TAHA D,et al. A randomised controlled trial evaluating renal protective effects of selenium with vitamins A,C,E,verapamil,and losartan against extracorporeal shockwave lithotripsy-induced renal injury[J]. Bju International,2016,119(1):142.
[15]田江宣,陈日秋,季晓珍,等.贝前列素钠联用氯沙坦钾对糖尿病肾病早期患者的临床研究[J].中国临床药理学杂志,2016,32(1):15-17.
[16]顾佩莉,蒋晓真,陈蕊华,等.氯沙坦钾对糖尿病肾病患者Chemerin,C反应蛋白,白细胞介素-6和尿微量白蛋白/肌酐比值的影响[J].上海医学,2016(7):413-416.
[17] STAMP LK,HASLETT J,FRAMPTON C,et al. The safety and efficacy of benzbromarone in gout in Aotearoa New Zealand[J].Internal Medicine Journal,2016,46(9):1075-1080.
[18] GLIOZZI M,MALARA N,MUSCOLI S,et al. The treatment of hyperuricemia[J]. International Journal of Cardiology,2016,213(1):23-27.