Department of Urology, the 3rd Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
Urol J. 2020 Apr 19;18(1):34-39. doi: 10.22037/uj.v0i0.5564.
This study aimed to investigate the efficacy and safety of febuxostat in patients with radiolucent nephrolithiasis.
From March 2016 to June 2018, data of 96 patients with radiolucent nephrolithiasis and hyperuricemia who referred to the Third Affiliated Hospital of Sun Yat-sen University were retrospectively analyzed. These patients were divided into allopurinol 300mg/d (control), febuxostat 40mg/d (F40) and 80mg/d (F80) groups respectively. All patients took potassium citrate as a combination treatment and had been followed up for at least 6 months. Before treatment and on after 1st, 3rd and 6th month, complete blood count, serum uric acid (sUA), hepatic and renal function as well as ultrasound were carried out. Arthritic and gastrointestinal symptoms were also monitored. Computed tomography was performed before treatment and 6 months after medication.
Compared with allopurinol group, F40 group showed no difference in urate-lowering effect, while F80 had the best effect across all the visits (P<0.01). At 6th month, 25(83.3%) cases of F80 group achieved sUA<6mg/ dL, which was better than allopurinol group (18 cases, 58.1%) and F40 group (17 cases, 58.6%). In the dissolution effect of radiolucent calculi, F80 had the best effect, followed by F40 and then allopurinol (P<0.05). No statistical difference was observed in adverse events among three groups.
Febuxostat significantly decreased sUA, promoted radiolucent stone dissolution and reduced the total stone number, whereas it did not increase the adverse events.
本研究旨在探讨非布司他治疗透光性肾结石患者的疗效和安全性。
回顾性分析 2016 年 3 月至 2018 年 6 月中山大学附属第三医院收治的 96 例透光性肾结石合并高尿酸血症患者的临床资料。将患者分为别嘌醇 300mg/d（对照组）、非布司他 40mg/d（F40 组）和 80mg/d（F80 组）。所有患者均服用枸橼酸钾作为联合治疗，并随访至少 6 个月。治疗前及治疗后 1、3、6 个月检测血常规、血尿酸（sUA）、肝肾功能及超声，同时监测关节炎及胃肠道症状。治疗前及治疗后 6 个月行 CT 检查。
与别嘌醇组相比，F40 组降尿酸效果无差异，而 F80 组在各访视点的效果最佳（P<0.01）。治疗 6 个月后，F80 组 25 例（83.3%）血尿酸<6mg/dL，明显优于别嘌醇组（18 例，58.1%）和 F40 组（17 例，58.6%）。在透光性结石溶解效果方面，F80 组效果最好，其次是 F40 组，然后是别嘌醇组（P<0.05）。三组不良反应发生率无统计学差异。
非布司他能显著降低血尿酸水平，促进透光性结石溶解，减少结石总数，且不增加不良反应。
