天津医药

天津医药 ›› 2018, Vol. 46 ›› Issue (10): 1102-1107.doi: 10.11958/ 20180796

• 循证医学 • 上一篇    下一篇

非布司他治疗慢性肾脏病伴高尿酸血症患者疗效及对 肾功能影响的Meta分析

龚书豪，卢婉君，欧阳柳荣，王缨△   

  1. 作者单位：南昌大学第一附属医院肾内科（邮编330006） 作者简介：龚书豪（1993），男，硕士在读，主要从事肾脏病临床与病理方面研究 △通讯作者 E-mail: wy1868@yeah.net
  • 收稿日期:2018-05-18 修回日期:2018-06-14 出版日期:2018-10-15 发布日期:2018-11-09
  • 通讯作者: 王缨 E-mail:289580472@qq.com

The efficacy of febuxostat in the treatment of chronic kidney disease with hyperuricemia and its influence in renal function: a Meta-analysis

GONG Shu-hao, LU Wan-jun, OUYANG Liu-rong, WANG Ying△   

  1. Department of Nephrology, the First Affiliated Hospital of Nanchang University，Nanchang 330006, China △Corresponding Author E-mail: wy1868@yeah.net
  • Received:2018-05-18 Revised:2018-06-14 Published:2018-10-15 Online:2018-11-09

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摘要： 摘要：目的 探讨非布司他治疗慢性肾脏病伴高尿酸血症患者的疗效及对肾功能的影响。方法 计算机检索 Pubmed、The Cochrance Central Rigster of Controlled Trials、OVID、Embase数据库及中国期刊全文数据库、中国生物医 学文献数据库、万方数据库、中国科技期刊数据库中有关非布司他治疗慢性肾脏病伴高尿酸血症患者疗效及对肾功 能影响的随机对照试验，筛选和提取资料后依据改良的Jadad评分量表对纳入的文献进行质量评价，采用RevMan 5.3 软件进行Meta分析。结果 纳入12篇随机对照试验，慢性肾脏病伴高尿酸血症患者共1 031例，其中非布司他组 516 例，对照组 515 例。Meta 分析结果示，非布司他对可反映疗效及肾功能的指标如血尿酸（MD=-61.28， 95%CI：-67.68~-54.88，P＜0.001）、血肌酐（MD=-31.51，95%CI：-36.25~-26.76，P<0.001）、血尿素氮（MD=-2.14， 95%CI：-2.87~-1.41，P<0.001）、估算肾小球滤过率（MD=4.13，95%CI：1.67~6.58，P=0.001）的影响优于对照组，且不良 反应发生率差异无统计学意义（OR=0.55，95%CI：0.15~1.92，P=0.35）。结论 非布司他治疗慢性肾脏病伴高尿酸血 症患者有一定的积极意义

关键词: 高尿酸血症, 肾功能不全, Meta分析, 非布司他, 慢性肾脏病

Abstract: Abstract：Objective To investigate the efficacy of febuxostat in hyperuricemic patients with chronic kidney disease and its influence in renal function. Methods All randomized controlled trials (RCTs) that focus on the efficacy of febuxostat and its effect on renal function in hyperuricemic patients with chronic kidney disease were screened from CNKI, CBM, WanFang, VIP, Embase, Pubmed, OVID and Cochrane library clinical controlled trials database. Data were extracted by two independent researchers, and the control of quality was evaluated from the modified Jadad rating scale. Meta analysis was then undertaken through RevMan 5.3 software. Results A total of 12 RCTs were obtained, including 1 031 patients with chronic kidney disease and hyperuricemia. Patients were divided into febuxostat group (n=516) and control group (n= 515). Meta-analysis results showed that the effects of febuxostat were significantly better than those of control group including serum uric acid (MD=-61.28, 95%CI: -67.68- -54.88, P ＜ 0.001), serum creatinine (MD=-31.51, 95%CI: -36.25- -26.76, P＜0.001), blood urea nitrogen (MD=-2.14, 95%CI: -2.87- -1.41, P＜0.001) and eGFR after treatment (MD=4.13, 95%CI: 1.67-6.58, P=0.001). There was no significant difference in the incidence of adverse reactions between the febuxostat group and the control group (OR=0.55, 95%CI: 0.15-1.92, P=0.35). Conclusion The current clinical evidences show that febuxostat has a better effect on the treatment of hyperuricemic patients with chronic kidney disease.

Key words: hyperuricemia, renal insufficiency, Meta-analysis, Febuxostat, chronic kidney disease