摘要
目的:探讨小剂量糖皮质激素联合秋水仙碱对上消化道出血合并急性痛风发作患者肾功能、炎症指标及疼痛-焦虑状态的影响。方法:前瞻性选择南平市第一医院2023年1月至2024年12月期间收治的上消化道出血合并急性痛风发作患者64例,按随机数字表法分为对照组和试验组,每组32例。对照组接受秋水仙碱治疗,试验组在对照组的基础上接受小剂量糖皮质激素治疗,两组均治疗5 d。对比两组治疗期间再出血率、总住院时间及复发率、肾功能与炎症指标[血肌酐(serum creatinine,Scr)、血尿素氮(blood urea nitrogen,BUN)、降钙素原(procalcitonin,PCT)、肿瘤坏死因子-α(tumor necrosis factor-α,TNF-α)]、痛风累及关节数量、焦虑自评量表(self-rating anxiety scale,SAS)评分、数字疼痛(numerical rating scale,NRS)评分和不良反应发生率。结果:试验组的总住院时间短于对照组(P<0.05),治疗期间再出血率无统计学差异(P>0.05),复发率低于对照组(P<0.05)。两组治疗5 d后Scr、PCT、BUN、TNF-α水平下降,且试验组低于对照组(P<0.05)。两组治疗5 d后痛风累及关节数量、NRS评分、SAS评分降低,且试验组低于对照组(P<0.05)。两组不良反应发生概率比较不存在统计学差异(P>0.05)。结论:小剂量糖皮质激素联合秋水仙碱治疗上消化道出血合并急性痛风发作患者,可有效改善临床症状和肾功能,减轻炎症反应和疼痛程度,缓解焦虑情绪,且未诱发或加重消化道出血。
Objective:To investigate the effects of low-dose glucocorticoids combined with colchicine on renal function,inflammatory markers and pain-anxiety status in patients with upper gastrointestinal bleeding and acute gout attacks.Methods:64 patients with upper gastrointestinal bleeding and acute gout attacks who were admitted to Nanping First Hospita from January 2023 to December 2024 were prospectively selected,and they were randomly divided into control group and experimental group,32 cases in each group.The control group received colchicine therapy,while the experimental group received low-dose glucocorticoid therapy on the bases of control group,both groups were treated for 5 d.The rebleeding rate during treatment,the total length of hospital stay and the recurrence rate,renal function and inflammatory indicators[serum creatinine(Scr),blood urea nitrogen(BUN),procalcitonin(PCT),tumor necrosis factor-α(TNF-α)],number of joints affected by gout,self-rating anxiety scale(SAS)score,numerical rating scale(NRS)score,and incidence of adverse reactions between the two groups were compared.Results:Compared with the control group,the total length of hospital stay in the experimental group were shorter(P<0.05).No significant differences were found in the rebleeding rate during treatment(P>0.05),and the recurrence rate was lower than that in the control group(P<0.05).5 d after treatment,the levels of Scr,PCT,BUN and TNF-αin both groups decreased,and experimental group were lower than those in the control group(P<0.05).5 d after treatment,the number of joints affected by gout,NRS score and SAS score in both groups decreased,and experimental group were lower than those in the control group(P<0.05).There was no statistically significant difference in the probability of adverse reactions between the two groups(P>0.05).Conclusion:Low-dose glucocorticoids combined with colchicine in upper gastrointestinal bleeding and acute gout attacks patients,can effectively improve clinical symptoms,kidney function,reduce inflammatory responses,pain levels and relieve anxiety with no induction or exacerbation of gastrointestinal bleeding.
作者
陆信顺
涂建军
薛文锦
张荣娟
苗卉
LU Xin-shun;TU Jian-jun;XUE Wen-jin;ZHANG Rong-juan;MIAO Hui(Department of Gastroenterology,Nanping First Hospital,Nanping,Fujian,353000,China;Department of Rheumatology and Immunology,Nanping First Hospital,Nanping,Fujian,353000,China)
出处
《现代生物医学进展》
2025年第23期3718-3724,3782,共8页
Progress in Modern Biomedicine
基金
福建省自然科学基金资助项目(2021J011424)。
关键词
糖皮质激素
秋水仙碱
上消化道出血
痛风
肾功能
炎症指标
疼痛
焦虑
Glucocorticoids
Colchicine
Upper gastrointestinal bleeding combined with acute gout attack
Renal function
Inflammatory marker
Pain
Anxiety
