新疆医科大学学报

目的观察碳酸氢钠、非布司他联合生活方式干预对肥胖合并高尿酸血症患者的干预效果。方法以2017年12月-2018年12月在保定市第一中心医院内分泌科就诊的肥胖合并高尿酸血症患者117例为研究对象,随机分为3组,每组均为39例,对照组接受生活方式干预,联合组A接受碳酸氢钠联合生活方式干预,联合组B接受非布司他联合生活方式干预,干预3个月后,分析比较3组患者干预前后血清脂肪因子水平、炎症因子水平、动脉内膜中层厚度、血尿酸水平、体质量、身体质量指数(BMI)的差异。结果干预前3组患者间游离脂肪酸(FFA)、总胆固醇(TC)、甘油三酯(TG)、脂联素(APN)水平比较,差异无统计学意义(P>0.05)。与本组干预前比较,干预后3组患者FFA、TC、TG水平均下降,APN水平上升,差异有统计学意义(P<0.05)。与对照组干预后比较,联合组A、联合组B患者干预后FFA、TC、TG水平均下降,APN水平上升,差异有统计学意义(P<0.05)。与本组干预前比较,干预后3组患者肿瘤坏死因子-α(TNF-α)、超敏C反应蛋白(hs-CRP)、白介素-6(IL-6)、颈动脉内膜中层厚度、血尿酸水平、体质量、BMI均降低,差异有统计学意义(P<0.05);与对照组比较,联合组A、联合组B干预后TNF-α、hs-CRP、IL-6、颈动脉内膜中层厚度、血尿酸水平、体质量、BMI均降低,差异有统计学意义(P<0.05);干预后联合组A与联合组B患者TNF-α、hs-CRP、IL-6水平、颈动脉内膜中层厚度、体质量、BMI比较,差异无统计学意义(P>0.05);与联合组A干预后比较,联合组B患者血尿酸水平降低,差异有统计学意义(P<0.05)。结论碳酸氢钠或非布司他联合生活方式干预对肥胖合并高尿酸血症患者有较好的治疗效果。

Objective To observe the intervention effect of sodium bicarbonate and febuxostat combined with lifestyle intervention on patients with obesity complicated with hyperuricemia. Methods 117 obese patients with hyperuricemia in the Department of Endocrinology Baoding First Central Hospital from December 2017 to December 2018 were divided into three groups, according to the different intervention schemes, 39 cases in each group. The control group received lifestyle intervention, and the combination group A received sodium bicarbonate combined lifestyle intervention, and the combination group B received febuxostat combined lifestyle intervention. After 3 months′ intervention, the levels of serum adipokines and inflammatory factors were measured, the carotid intima-media thickness, serum uric acid level, body mass index(BMI) were compared. Results There was no significant difference in FFA, TC, TG and APN among the three groups before intervention(P>0.05). Compared with the group before the intervention, the levels of FFA, TC, TG in the three groups decreased after the intervention, while APN level increased, and the difference was statistically significant(P<0.05). Compared with the control group, the levels of FFA, TC, TG and APN in the combined group A and B decreased significantly(P<0.05). TNF-α, hs CRP, IL-6, carotid intima-media thickness, blood uric acid level, body mass and BMI in the three groups decreased significantly after the intervention(P<0.05); compared with the control group, TNF-α, hs CRP, IL-6 and carotid artery in the combined group A and B. There was no significant difference in TNF-α, hs CRP, IL-6, carotid intima-media thickness, body mass and BMI between the combined group A and the combined group B(P>0.05); compared with the combined group A, there was significant difference in serum uric acid level(P<0.05). Conclusion Sodium bicarbonate or febuxostat combined with lifestyle intervention has a better therapeutic effect on obese patients with hyperuricemia.