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药物性高尿酸血症对尼日利亚肺结核患者肾功能的影响。

Effect of drug-induced hyperuricaemia on renal function in Nigerians with pulmonary tuberculosis.

作者信息

Adebisi S A, Oluboyo P O, Okesina A B

机构信息

Department of Chemical Pathology & Immunology, University of Ilorin, Nigeria.

出版信息

Afr J Med Med Sci. 2000 Sep-Dec;29(3-4):297-300.

Abstract

Some anti-tuberculosis chemotherapeutic agents have been established as causing hyperuricaemia. Hyperuricaemia in turn causes renal damage. This study therefore aims at establishing the effect of anti-tuberculosis drugs-induced hyperuricaemia on renal function of the patients. Fifty patients with newly diagnosed pulmonary tuberculosis with mean age of 36.8 years (SD 13.69) consisting of 14 females and 17 males were longitudinally studied each for 6 months to determine the effect of drug-induced hyperuricaemia on their renal function. The Biochemical indices determined included serum urate level, serum creatinine level, and creatinine clearance of newly diagnosed patient with tuberculosis, before and during treatment with anti-tuberculosis therapy. Serum urate level revealed that 16 (51.6%) and 15 (48.4%) of the patients were hyperuricaemic at the end of the first and second months of anti-tuberculosis therapy. There was no significant difference in the mean serum creatinine level of the control group 96 micromol/L when compared with both the pre-treat value 89 micromol/L (P > 0.25) as well as the value at the end of the sixth month of treatment 91 micromol/L (P > 0.40). However, there was a statistically significant difference in the mean creatinine clearance of the control group 102 ml/min/1.73 m2 when compared with the patient's mean pre-treatment value (89 ml/min/1.73 m2) P < 0.05. Also the mean creatinine clearance increased to (103 ml/min/1.73 m2) by the end of the 6th month of treatment, a value that is statistically significant when compared with the pretreatment value of (89 ml/min/1.73 m2) P < 0.05. We submit as follows: that pulmonary tuberculosis as a disease with significant impairment of renal function; despite the associated drug-induced hyperuricaemia recorded during the treatment, renal function steadily improved with the treatment of pulmonary tuberculosis to the extent that comparable values with control was obtained at the end of treatment. We conclude therefore that drug-induced hyperuricaemia associated with treatment of pulmonary tuberculosis has no detectable negative effect on renal function of the patient.

摘要

一些抗结核化疗药物已被证实可导致高尿酸血症。高尿酸血症进而会引起肾脏损害。因此,本研究旨在确定抗结核药物所致高尿酸血症对患者肾功能的影响。对50例新诊断的肺结核患者进行了为期6个月的纵向研究,这些患者平均年龄为36.8岁(标准差13.69),其中女性14例,男性17例,以确定药物性高尿酸血症对其肾功能的影响。所测定的生化指标包括新诊断肺结核患者在抗结核治疗前及治疗期间的血清尿酸水平、血清肌酐水平和肌酐清除率。血清尿酸水平显示,在抗结核治疗的第一个月末和第二个月末,分别有16例(51.6%)和15例(48.4%)患者出现高尿酸血症。对照组的平均血清肌酐水平为96微摩尔/升,与治疗前值89微摩尔/升相比(P>0.25)以及与治疗第六个月末的值91微摩尔/升相比(P>0.40),均无显著差异。然而,对照组的平均肌酐清除率为102毫升/分钟/1.73平方米,与患者治疗前的平均水平(89毫升/分钟/1.73平方米)相比,差异具有统计学意义(P<0.05)。此外,治疗第6个月末平均肌酐清除率增加到(103毫升/分钟/1.73平方米),与治疗前值(89毫升/分钟/1.73平方米)相比,该值具有统计学意义(P<0.05)。我们提出如下观点:肺结核是一种严重损害肾功能的疾病;尽管在治疗期间记录到了相关的药物性高尿酸血症,但随着肺结核的治疗,肾功能稳步改善,在治疗结束时获得了与对照组相当的值。因此,我们得出结论,与肺结核治疗相关的药物性高尿酸血症对患者肾功能没有可检测到的负面影响。

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