Gong Zhen, Xia Li, Xu Rune, Luo Min, Deng Hongxiang, Kang Zhiping, Liu Leping, Liu Yaqing, Zhang Fangjie, Shi Jian
Department of Rheumatology, Yiyang Central Hospital, Yiyang, Hunan, People's Republic of China.
Department of Emergency Medicine, Xiangya Hospital, Central South University, Changsha, Hunan, People's Republic of China.
J Inflamm Res. 2021 Sep 7;14:4509-4517. doi: 10.2147/JIR.S329800. eCollection 2021.
The purpose of the study was to retrospectively analyze the effects of febuxostat combined with arthroscopic debridement of monosodium urate crystal deposition and febuxostat treatment alone on uric acid levels and acute flares in gout patients.
We retrospectively analyzed gout patients who were treated from February 2016 to December 2020. Patients were divided into a control group (febuxostat treatment alone) or a combined group (febuxostat combined with arthroscopic surgery). We recorded and analyzed clinical data including age, sex, body mass index, comorbidities, lesion affected joints, acute flare times, medications history, febuxostat side effects, arthroscopic complications, and serum creatinine and uric acid levels changes.
There were 80 patients in the control group and 93 patients in the combined group. At the beginning of treatment, the combined group had significantly higher disease severity (higher serum uric acid levels and more acute gout flare times). Arthroscopy was performed in 61 knees and 38 ankles, and 86 joints showed crystals deposition. Compared with baseline, follow-up results showed that serum creatinine significantly decreased in the combined group, and serum uric acid and acute gout flare times significantly decreased in both groups (all < 0.05). In the comparison between the two groups at the follow-up endpoint, acute gout flare times did not differ significantly ( > 0.05), however, serum creatinine and uric acid levels were lower in the combined group compared with those in the control group (s < 0.05).
Febuxostat combined with arthroscopic debridement of monosodium urate crystal deposition or tophi had a superior effect on lowering uric acid levels and acute flare times in gout patients than did febuxostat alone.
本研究旨在回顾性分析非布司他联合关节镜下清除尿酸钠晶体沉积与单纯非布司他治疗对痛风患者尿酸水平及急性发作的影响。
我们回顾性分析了2016年2月至2020年12月期间接受治疗的痛风患者。患者被分为对照组（单纯非布司他治疗）或联合组（非布司他联合关节镜手术）。我们记录并分析了临床数据，包括年龄、性别、体重指数、合并症、受累关节、急性发作次数、用药史、非布司他副作用、关节镜并发症以及血清肌酐和尿酸水平变化。
对照组有80例患者，联合组有93例患者。治疗开始时，联合组疾病严重程度显著更高（血清尿酸水平更高，急性痛风发作次数更多）。对61个膝关节和38个踝关节进行了关节镜检查，86个关节显示有晶体沉积。与基线相比，随访结果显示联合组血清肌酐显著降低，两组血清尿酸和急性痛风发作次数均显著降低（均P<0.05）。在随访终点两组比较中，急性痛风发作次数差异无统计学意义（P>0.05），然而，联合组血清肌酐和尿酸水平低于对照组（P<0.05）。
非布司他联合关节镜下清除尿酸钠晶体沉积或痛风石对降低痛风患者尿酸水平及急性发作次数的效果优于单纯非布司他。
