糖尿病肾病伴高尿酸血症患者应用非布司他治疗的效果及对肾功能的影响

Effect of febuxostat on diabetic nephropathy with hyperuricemia and its influence on renal function

摘要:

目的 探讨糖尿病肾病伴高尿酸血症患者应用非布司他治疗的效果及对肾功能的改善作用。方法 选取方城县人民医院2021年1月至2022年10月收治的糖尿病肾病伴高尿酸血症患者83例，随机数字表法分成两组，均接受糖尿病常规治疗，其中一组41例增加别嘌醇片治疗为对照组，另一组42例增加非布司他治疗为观察组。两组均治疗3个月，随访6个月。比较两组各项指标。结果 观察组、对照组临床总有效率比较，前者更高；观察组、对照组治疗前、治疗后血清尿酸（SUA）水平、尿白蛋白排泄率（UAER）水平、微量白蛋白尿（MAU）水平、尿白蛋白肌酐比（ACR）水平、胰岛素抵抗指数（HOMA-IR）、血清空腹胰岛素（FINS）、餐后2 h血糖（2hPG）水平比较，均降低，组间比较，前者均更低；观察组、对照组随访期间不良反应总发生率比较，前者更低（均P<0.05）。结论 非布司他可以提高糖尿病肾病伴高尿酸血症患者治疗效果，降低血尿酸水平，改善血糖水平及肾功能，减少不良反应。

Abstract:

Objective To investigate the effect of febuxostat on diabetic nephropathy with hyperuricemia and its improvement on renal function.Methods From January 2021 to October 2022, 83 cases of diabetic nephropathy with hyperuricemia in Fangcheng County People's Hospital were selected. According to the random number table method, they were divided into two groups, all of whom received routine treatment of diabetes. One group of 41 cases treated with allopurinol tablets was selected as the control group, and the another group of 42 cases treated with febuxostat was selected as the observation group. Both groups were treated for 3 months and followed up for 6 months. The indexes of the two groups were compared.Results Compared with the control group, the clinical total effective rate of the observation group was higher. Compared with before treatment, the levels of serum uric acid (SUA), urinary albumin excretion rate (UAER), microalbunminuria (MAU), urinary albumin-to-creatinine ratio (ACR), homeostatic model assessment for insulin resistance (HOMA-IR), serum fasting insulin (FINS) and 2-hour postprandial blood glucose (2hPG) of the observation group and the control group decreased after treatment, and the former was even lower. The total incidence of adverse reactions of the observation group was lower than that of the control group during the follow-up period (all P<0.05).Conclusion Febuxostat can improve the therapeutic effect of diabetic nephropathy with hyperuricemia, reduce the level of serum uric acid, improve the level of blood sugar and renal function, and reduce adverse reactions.