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目的:观察苯溴马隆治疗高尿酸血症对慢性肾功能不全(CKD)患者肾功能的影响。方法:选择伴有高尿酸血症的CKD 3或4期患者53例,随机分为观察组22例和对照组31例。观察组苯溴马隆起始剂量为25mg/d,最大剂量不超过100mg/d;对照组不使用苯溴马隆及其他降尿酸药物治疗。比较两组治疗3个月、6个月、12个月和24个月时平均动脉压(MAP)、24h尿蛋白定量、血红蛋白、C反应蛋白(CRP)、血尿酸、血肌酐水平,并计算肾小球滤过率(eGFR)的变化;同时记录观察组不良反应发生情况。结果:两组各时间节点MAP、24h尿蛋白定量、血红蛋白及CRP水平与同组治疗前均差异不显著(P>0.05),各时间节点两组组间比较也差异不显著(P>0.05)。观察组治疗3个月、6个月、12个月、24个月时血尿酸水平显著低于治疗前,且显著低于对照组(P<0.05)。对照组治疗12个月、24个月时,血肌酐水平显著高于治疗前,且显著高于观察组(P<0.05);eGFR显著降低,且显著低于观察组(P<0.05)。结论:苯溴马隆治疗可降低CKD 3或4期患者血尿酸水平,并延缓肾功能损害的进展。
Objective: To observe the effect of benzbromarone on renal function in patients with chronic renal insufficiency (CKD). Methods: Fifty-three patients with CKD stage 3 or 4 with hyperuricemia were randomly divided into observation group (n = 22) and control group (n = 31). The initial dose of benzbromarone in the observation group was 25 mg / day and the maximum dose did not exceed 100 mg / day. The control group did not use benzbromarone and other uric acid lowering drugs. Mean arterial pressure (MAP), urinary protein excretion, hemoglobin, C-reactive protein (CRP), serum uric acid and serum creatinine were calculated at 3, 6, 12 and 24 months after treatment Glomerular filtration rate (eGFR) changes; also recorded the observation group adverse reactions. Results: The levels of urinary protein, hemoglobin and CRP in MAP and 24h groups were not significantly different from those in the same group (P> 0.05) at each time point. There was no significant difference between the two groups at each time point (P> 0.05) . The level of serum uric acid in observation group at 3, 6, 12 and 24 months was significantly lower than that before treatment and significantly lower than that in control group (P <0.05). The level of serum creatinine was significantly higher in the control group at 12 months and 24 months than that before treatment and significantly higher than that in the observation group (P <0.05). The eGFR of the control group was significantly lower than that of the control group (P <0.05). Conclusion: Benzbromarone treatment can reduce serum uric acid level in CKD stage 3 or 4 patients and delay the progression of renal dysfunction.