Department of Medicine, University of Otago, Christchurch 8140, New Zealand.
Rheumatology (Oxford). 2012 Sep;51(9):1670-6. doi: 10.1093/rheumatology/kes091. Epub 2012 Apr 26.
To determine the effects of furosemide on serum urate (SU), plasma oxypurinol and urinary urate.
Twenty-three cases with gout receiving furosemide and allopurinol were recruited. Twenty-three controls with gout receiving allopurinol but no diuretics were matched on age, gender, estimated glomerular filtration rate and allopurinol dose. SU, plasma oxypurinol and urinary urate were assessed on a single occasion. The effects of a single dose of furosemide 40 mg were examined in a separate group of 10 patients receiving allopurinol but not diuretic.
Cases had significantly higher SU and plasma oxypurinol compared with controls despite receiving similar doses of allopurinol. There was no difference in urinary urate excretion. There was a significant increase in area under the curve (AUC)(0-24) for oxypurinol after administration of furosemide 40 mg.
The interaction between allopurinol and furosemide results in increased SU and plasma oxypurinol. The exact mechanisms remain unclear but complex interactions that result in attenuation of the hypouricaemic effects of oxypurinol are likely.
Australian New Zealand Clinical Trials Registry, www.anzctr.org.au, 12609000529246.
确定速尿对血清尿酸（SU）、血浆氧嘌呤醇和尿尿酸的影响。
招募了 23 例接受速尿和别嘌醇治疗的痛风患者，并与 23 例接受别嘌醇但未使用利尿剂的痛风对照者按年龄、性别、估计肾小球滤过率和别嘌醇剂量相匹配。在单次就诊时评估 SU、血浆氧嘌呤醇和尿尿酸。在接受别嘌醇但未使用利尿剂的 10 例患者中，单独检查了单次 40mg 速尿的作用。
尽管接受了相同剂量的别嘌醇，但病例组的 SU 和血浆氧嘌呤醇明显高于对照组。尿尿酸排泄无差异。给予速尿 40mg 后，氧嘌呤醇的 AUC（0-24）显著增加。
别嘌醇和速尿之间的相互作用导致 SU 和血浆氧嘌呤醇升高。确切的机制尚不清楚，但可能是复杂的相互作用导致氧嘌呤醇的降尿酸作用减弱。
澳大利亚新西兰临床试验注册中心，www.anzctr.org.au，12609000529246。
