目的：探讨非布司他用于治疗痛风伴高尿酸血症对炎症状态及血管内皮细胞功能的影响。方法选择2013年6月至2014年12月收治的痛风伴高尿酸血症患者60例，随机分为对照组与观察组，各30例。对照组患者给予别嘌呤醇300 mg口服治疗，每次100 mg，3次/日；观察组患者给予非布司他80 mg口服治疗，每次80 mg，1日/次，疗程均为24周。观察两组患者临床症状及体征，评估治疗效果，检测治疗前后两组患者血清白细胞介素1β（IL－1β）、IL－6、肿瘤坏死因子－α（TNF－α）、内皮素－1（ET－1）水平以及不良反应发生情况。结果治疗后，两组患者总有效率比较，差异无统计学意义（ P>0.05）；两组IL－1β，IL－6，TNF－α水平较治疗前均明显下降，差异有统计学意义（ P0.05）；两组患者ET－1水平均下降，且观察组比对照组下降更明显（ P0.05）。结论非布司他治疗痛风伴高尿酸血症能有效降低患者的高尿酸状态，抑制炎症因子表达，改善血管内皮细胞功能，且不良反应较少，安全性较高。%Objective To investigate the effect of febuxostat on the inflammatory state and the function of vascular endothelial cells in the treatment of gout with hyperuricemia. Methods 60 cases of gout with hyperuricemia from June 2013 to December 2014 were se-lected and randomly divided into the control group and the observation group, 30 cases in each group. The control group received 300 mg of allopurinol oral treatment, 100 mg/times, tid; the observation group received 80 mg of febuxostat oral treatment, 80 mg/times, qd. Treatment period of both groups lasted for 24 weeks. The clinical symptoms and signs were observed, the treatment effect was evalu-ated, the levels of serum interleukin 1 β ( IL-1β) , interleukin 6 ( IL-6 ) serum tumor necrosis factor-α ( TNF-α) and endothelin-1 ( ET-1 ) before and after treatment in the two groups were detected, and the incidence of adverse reactions were recorded. Results Af-ter treatment, There was no significant difference between the two groups in the total effective rate ( P > 0. 05 );the levels of IL-1β, IL-6 and TNF-α in the two groups were significantly lower than those before treatment ( P 0. 05 );the levels of ET-1 in the two groups were significantly lower than those before, and the decrease in the observa-tion group was more significant ( P 0. 05 ) . Conclusion Febuxostat in the treatment of gout with hyperuricemia can effectively decrease the hyperuricemia, inhibit the expression of inflammatory factors and improve the function of vascular endothelial cells. The adverse reactions are less and the safety is higher.
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