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血清尿酸下降对中风发作风险的影响,在中国男性痛风患者中开始尿酸降低疗法时:一项前性队列研究
Lei Pang1,2,3,4, Xiaomei Xue1,2,3,4, Yuwei He1,2,3,4
1Shandong Provincial Clinical Research Center for Immune Diseases and Gout, the Affiliated Hospital of Qingdao University, Qingdao, 266003, People's Republic of China.
基线血清尿酸水平较高和血清尿酸水平较大降低在开始尿酸降低疗法时增加痛风发作风险. 控制血清尿酸水平是预防爆发的关键.
科学领域:
- 类风湿病学 类风湿病学
- 临床药理学 临床药理学
背景情况:
- 开始尿酸降低疗法 (ULT) 可以矛盾地增加痛风发作.
- 血清尿酸减少的速度与ULT诱导的爆发有关.
研究的目的:
- 为了研究血清尿酸盐下降与在ULT启动期间痛风爆发的风险之间的关联.
- 了解基线血清尿酸盐水平在ULT诱导爆发中的作用.
主要方法:
- 一项为期12周的前性队列研究,包括260名中国男性痛风患者.
- 患者根据基线和每周血清尿酸盐水平接受了费布克斯托特升级剂量.
- 普森回归分析被用来确定痛风爆发的风险因素.
主要成果:
- 在研究期间,至少发生了一次痛风发作的发生率为44.2%.
- 在初步分析中,血清尿酸盐 (Δ血清尿酸盐0-12周) 的较大降低与痛风发作增加有关 (IRR 1.184).
- 然而,在对基线因素进行调整的第二次分析中,血清尿酸水平的下降并不是一个显著的风险因素,而较高的基线血清尿酸水平仍然显著 (IRR为1.256).
结论:
- 血清尿酸下降的程度会影响ULT诱导的痛风发作.
- 血清尿酸基线较高和血清尿酸水平较大降低,都会增加患痛风的风险.
- 仔细管理基线血清尿酸和ULT定位对于预防发作至关重要.
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