【摘要】 目的：比較不同剂量非布司他联合依托考昔、别嘌呤醇对高尿酸血症合并痛风患者的疗效。方法：选取2018年4月-2020年4月本院收治的85例高尿酸血症合并痛风患者。按电脑随机数字表法将其分为低剂量组（n=42）与高剂量组（n=43）。两组均予以非布司他、依托考昔、别嘌呤醇联合方案治疗，其中低剂量组非布司他剂量为40 mg/d，高剂量组非布司他剂量为80 mg/d。两组依托考昔与别嘌呤醇给药剂量一致。对比两组治疗前后血管内皮素-1、血尿酸、血清IL-6及hs-CRP水平;对比两组临床疗效与不良反应发生情况。结果：低剂量组治疗总有效率为97.62%，与高剂量组的95.35%比较，差异无统计学意义（P>0.05）。两组治疗后血管内皮素-1与血尿酸水平均低于治疗前（P<0.05）;治疗前后两组间血管内皮素-1与血尿酸水平比较，差异均无统计学有意义（P>0.05）。低剂量组不良反应发生率为9.52%，低于高剂量组的30.23%（P<0.05）。治疗前后两组间血清IL-6及hs-CRP水平比较，差异均无统计学意义（P>0.05）。结论：不同剂量非布司他联合依托考昔、别嘌呤醇治疗高尿酸血症合并痛风患者的效果均较佳，且对IL-6、hs-CRP、血管内皮素-1、血尿酸水平的影响程度相当，但低剂量非布司他可有效降低不良反应的发生。

【关键词】 高尿酸血症 痛风 非布司他 依托考昔 别嘌呤醇

Comparison of Different Doses of Febuxostat Combined with Etoricoxib and Allopurinol in the Treatment of Hyperuricemia Complicated with Gout/ZHU He. //Medical Innovation of China， 2021， 18（34）： 0-055

[Abstract] Objective： To compare the efficacy of different doses of Febuxostat combined with Etoricoxib and Allopurinol in hyperuricemia complicated with gout. Method： A total of 85 patients with hyperuricemia complicated with gout admitted to our hospital from April 2018 to April 2020 were selected. They were divided into low-dose group （n=42） and high-dose group （n=43） by computer random number table method. Both groups were treated with Febuxostat， Etocoxib and Allopurinol combined regimen， with Febuxostat dose of 40 mg/d in the low-dose group and 80 mg/d in the high-dose group. The dose of Etocoxib and Allopurinol was the same in both groups. The levels of endothelin-1， serum uric acid， IL-6 and hs-CRP were compared between the two groups before and after treatment. The clinical efficacy and adverse reactions of the two groups were compared. Result： The total effective rate of low-dose group was 97.62%， and there was no statistical difference compared with 95.35% of high-dose group （P>0.05）. After treatment， the levels of vascular endothelin-1 and serum uric acid in two groups were lower than those before （P<0.05）. There were no significant differences in endothelin-1 and serum uric acid levels between the two groups before and after treatment （P>0.05）. The incidence of adverse reactions in low-dose group was 9.52%， which was lower than 30.23% in high-dose group （P<0.05）. There were no significant differences in serum IL-6 and hs-CRP levels between two groups before and after treatment （P>0.05）. Conclusion： Different doses of Febuxostat combined with Etecoxib and Allopurinol have better effects in the treatment of hyperuricemia complicated with gout， and have similar effects on IL-6， hs-CRP， endothelin-1 and serum uric acid levels， but low doses of Febuxostat can effectively reduce the occurrence of adverse reactions.

[Key words] Hyperuricemia Gout Febuxostat Etoricoxib Allopurinol

First-author’s address： Shenyang Jishuitan Hospital， Shenyang 110000， China

doi：10.3969/j.issn.1674-4985.2021.34.012

高尿酸血症属于临床上较为常见的一种代谢型疾病，机体尿酸排泄异常和/或嘌呤代谢异常是该病的重要发病机制[1-2]。目前，临床上针对该病的治疗以药物治疗为主，传统药物为嘌呤醇，该药可有效降低尿酸的水平，促进患者血管内皮功能的改善，然而单纯应用该药可能导致机体出现一系列不良反应，继而影响临床疗效[3]。……