目的 探讨非布司他治疗维持性血液透析伴高尿酸血症对患者肝功能、血清炎性因子水平的影响.方法 维持性血液透析 (透龄〉6个月)伴高尿酸血症患者34例随机分为非布司他组和对照组,每组17例.对照组采用常规治疗,非布司他组在对照组基础上加用非布司他进行治疗.观察肝功能[丙氨酸氨基转移酶( ALT)、天冬氨酸氨基转移酶(AST)、白蛋白(ALB)、胆固醇(TC)、三酰甘油( TG)]、血尿酸( SUA)、炎性因子[超敏C-反应蛋白( hs-CRP)、白细胞介素(IL)-6、肿瘤坏死因子(TNF)-α]水平.结果 2组治疗前,治疗1、3个月ALT、AST、ALB、TG、TC组内两两比较,差异无统计学意义(P>0. 05). 2组治疗前ALT、AST、ALB、TG、TC比较,差异无统计学意义(P>0. 05).非布司他组治治疗3个月ALT、AST水平均低于对照组,差异均有统计学意义(P<0. 05).对照组治疗前,治疗1、3个月SUA,差异无统计学意义(P>0. 05),治疗3个月BUN水平低于治疗前,差异有统计学意义(P<0. 05).非布司他组治疗前,治疗1、3个月SUA水平两两比较差异有统计学意义(P<0. 05). 2组治疗前SUA,差异无统计学意义(P>0. 05).非布司他组治疗1个月SUA低于对照组,差异有统计学意义(P<0. 05). 2组治疗前,治疗1、3个月hs-CRP、TNF-α水平组内两两比较,差异有统计学意义(P<0. 05),2组治疗3个月IL-6水平均低于治疗前,且非布司他组治疗1个月IL-6水平低于治疗前,差异均有统计学意义(P<0. 05). 2组治疗前hs-CRP、IL-6、TNF-α水平比较,差异无统计学意义(P>0. 05),非布司他组治疗1、3个月hs-CRP、IL-6、TNF-α水平均低于对照组,差异有统计学意义(P<0. 05).结论 非布司他治疗维持性血液透析伴高尿酸血症对患者肝功能影响较小,可以明显降低尿酸水平,有效减少炎性反应.%Objective To investigate the effects of febuxostat on serum inflammatory factors levels and liver function of patients with maintenance hemodialysis complicated by hyperuricemia. Methods Thirty-four patients with maintenance hemodialysis (over 6 months) complicated by hyperuricemia were randomly divided into febuxostat treatment group and control group,with 17 patients in each group. The patients in control group were treated by conventional therapy,however,the patients in febuxostat treatment group,on the basis of control group,were treated by febuxostat. The liver function including alanine aminotransferase (ALT),aspartate aminotransferase (AST),albumin (ALB),cholesterol ( TC) and triglyceride ( TG),blood uric acid ( SUA ) and renal function including Scr and blood urea nitrogen ( BUN ), inflammatory factors inclding hypersensitivity C-reactive protein (hs-CRP),interleukin (IL)-6,tumor necrosis factor (TNF)-α levels were observed and compared between the two groups. Results There were no significant differences in the levels of ALT,AST,ALB,TG and TC before treatment and at 1m,3m after treatment between the two groups (P>0. 05). The levels of ALT and AST at 3m after treatment in febuxostat treatment group were significantly lower than those in control group (P<0. 05). Moreover there were no significant differences in the levels of SUA in control group before treatment and at 1m,3m after treatment (P >0. 05), however there were significant differences in the levels of SUA in febuxostat treatment group before treatment and at 1m,3m after treatment each other (P<0. 05). Before treatment there were no significant differences in the levels of SUA between the two groups (P>0. 05),however,which in febuxostat treatment group at one month after treatment were significantly lower than those in control group (P<0. 05). There were significant differences in the levels of hs-CRP and TNF-α in both groups bfore treatment and at 1m, 3m after treatment each other (P<0. 05),and the IL-6 levels after 3-month treatment in both groups were significantly lower than those before treatment (P<0. 05),moreover,which in febuxostat treatment group after 1-month treatment were significantly lower than those before treatment (P<0. 05). Before treatment there were no significant differences in the levels of hs-CRP,IL-6 and TNF-α between the two groups (P >0. 05),however,which in febuxostat treatment group at 1m,3m after treatment were significantly lower than those in control group (P<0. 05). Conclusion The maintenance hemodialysis with febuxostat has less effects on liver function of patients with hyperuricemia,which can obviously reduce uric acidthe levels and effectively relieve inflammatory reaction of patients.
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