广东省佛山市居民高尿酸血症及痛风的流行病学调查

目的 明确广东省佛山市20岁以上居民高尿酸血症(HUA)和痛风的患病率及其影响因素.方法 采用随机、分层、整群抽样方法,调查佛山市5个区常住居民7403人HUA及痛风的患病情况.结果 (1)该市居民HUA患病率为15.09%,标化率为15.27%;其中男性为19.90%,女性为10.54%.痛风患病率为1.04%,标化率为1.08%;其中男性为1.73%,女性为0.39%.HUA患者痛风的发病率为6.89%.(2)整体人群血尿酸水平为(336.4±81.5)μmol/L,男性血尿酸水平高于女性,HUA患者男性血尿酸水平高于女性.(3)HUA组和痛风组年龄、BMI、SBP、DBP、血尿酸、血糖、TG、TC水平均明显高于正常组(P＜0.05～0.01),超重和肥胖、高血压、高血糖、血脂异常的发生率均显著高于正常组(P＜0.05).痛风组患病年龄、TG、血尿酸水平明显高于HUA组(P＜0.05).(4)非条件1ogistic多元逐步回归分析显示,年龄、超重、高血压病、糖尿病、血脂异常、服用利尿剂、家族史、饮酒、进食海产品、喝肉汤、女性绝经等是HUA的危险因素.饮茶、食新鲜蔬菜和水果等是HUA的保护因素.结论 佛山地区居民HUA及痛风的患病率处在较高水平.减少富含嘌呤食品及酒精的摄入量和频率,控制肥胖、控制高血压等是防治HUA和痛风的重要措施.     

珠海市干部人群高尿酸血症患病率相关性分析

目的:了解机关干部高尿酸血症人群分布情况,分析体质指数(BMI)、血脂异常、饮酒、饮食习惯以及高嘌呤食物与其患病率的相关性。方法:以2008年度珠海市干部体检人群为研究对象,向其发放调查问卷,了解其饮食结构、劳动强度、运动、饮酒等生活习惯,并分别测定其BMI、血尿酸(UA)、血糖(Glu)、血清总胆固醇(TC)、三酰甘油(TG)、高密度脂蛋白胆固醇(HDL-C)、低密度脂蛋白胆固醇(LDL-C)水平。结果:珠海市干部人群高尿酸血症总患病率为35.42%,并随年龄增长而上升,有年轻化的趋势,以中老年人为主,其中男性患病率(43.74%)显著高于女性(15.39%)。高尿酸血症人群并发脂肪肝、超重或肥胖(BMI≥24)、高TC血症、高TG血症、LDL-C增高、HDL-C降低的患病率远远高于非高尿酸血症人群(P0.05)。经常摄入高嘌呤饮食者高尿酸血症的患病率明显增高。结论:干部体检人群高尿酸血症患病率随年龄增长而上升,有年轻化的趋势,并与性别、超重或肥胖、血脂异常、高嘌呤食物呈显著正相关性。     

中山市干部群体高尿酸血症发病情况调查

目的了解中山市干部群体高尿酸血症的发病率及其相关因素。方法对2009年在本院进行健康体检的1566名处以上干部的血尿酸水平以及其他相关情况进行统计学分析。结果高尿酸血症和尿酸正常者分别为695例和871例,高尿酸血症的患病率为44．38％,男性高尿酸血症的患病率为49．67％,高于女性（10．04％）;患高尿酸血症组的高血压、高胆固醇血症、高甘油三脂血痘、肥胖的发生率均高于尿酸正常组。结论高尿酸血症与高血压、高血脂、肥胖密切相关,注意血尿酸的检查,重视高尿酸血症及其伴随表现的防治,对提高中老年人的健康水平有重要意义。     

别嘌呤醇对伴高尿酸血症慢性心力衰竭患者心功能和血尿酸水平的影响

目的观察别嘌呤醇对慢性心力衰竭患者心功能和血尿酸水平的影响。方法选择伴高尿酸血症慢性心力衰竭患者48例,随机分为常规治疗组(对照组)和别嘌呤醇组(治疗组),前者采用标准抗心衰治疗,后者在标准抗心衰治疗基础上加用别嘌呤醇300mg/d,疗程12周。采用超声心动图测定治疗前后左室舒张末期内径(LVEdD)、左室收缩末期内径(LVEdS),并计算EF值;同时检测治疗前后血尿酸水平。结果别嘌呤醇组血尿酸水平下降(P<0.05),左室舒张末期内径缩小(P<0.05),EF值升高(P<0.05)。结论别嘌呤醇治疗能降低血清尿酸水平,抑制氧化应激,显著改善高尿酸血症慢性心力衰竭患者的心功能和预后。     

别嘌呤醇对伴高尿酸血症慢性心力衰竭患者心功能和血尿酸水平的影响

目的观察别嘌呤醇对慢性心力衰竭患者心功能和血尿酸水平的影响。方法选择伴高尿酸血症慢性心力衰竭患者48例,随机分为常规治疗组(对照组)和别嘌呤醇组(治疗组),前者采用标准抗心衰治疗,后者在标准抗心衰治疗基础上加用别嘌呤醇300mg/d,疗程12周。采用超声心动图测定治疗前后左室舒张末期内径(LVEdD)、左室收缩末期内径(LVEdS),并计算EF值;同时检测治疗前后血尿酸水平。结果别嘌呤醇组血尿酸水平下降(P<0.05),左室舒张末期内径缩小(P<0.05),EF值升高(P<0.05)。结论别嘌呤醇治疗能降低血清尿酸水平,抑制氧化应激,显著改善高尿酸血症慢性心力衰竭患者的心功能和预后。     

2661例深圳市民血尿酸水平调查

调查深圳市民血尿酸值的水平、性别差异和年龄差异及其与有关疾病的相关关系。方法 :调查1999年深圳市民 2 6 6 1例健康人的血尿酸、血脂水平 ,在血尿酸值增高者检查肾脏B超、肾功能 (血清尿素氮、肌酐 ) ,对数据进行统计比较。结果 :在 2 6 6 1例深圳市民中 ,血尿酸超过 390 μmol/L以上者 5 6 0例 ,占2 1.0 4 % ;血尿酸值存在明显性别差异 ;高尿酸血症发病率随年龄增加而上升 ,尤以女性 5 0岁以后增加明显 ;高尿酸血症和高脂血症呈正相关 ;2 1.2 5 %高尿酸血症者并发痛风性关节炎、尿路结石和尿酸性肾病。结论 :血尿酸值存在性别、年龄差别 ,并与有关疾病相关。深圳人血尿酸值有逐渐上升趋势。     

高尿酸血症112例临床分析

为探讨高尿酸血症（Ｈｙｐｅｒｕｒｉｃｅｍｉａ，Ｈｕｍ）与多种疾病的关系，我们对２２２例住院患者进行了血尿酸（ＳＵＡ）测定，发现Ｈｕｍ１１２例，检出率高达５０．５％，合并糖尿病３５例（３１．３％）、高血压病２７例（２４．１％）、冠心病４８例（４２．９％）、脑梗塞１８例（１６．１％），痛风８例（７．１％），在冠心病中心律失常２０例（１７．９％），除高血压病以外，与对照组相比都有非常显著差异（Ｐ＜０．０１），说明Ｈｕｍ是上述疾病的危险因素，建议临床工作者应重视ＳＵＡ的测定，在预防和治疗Ｈｕｍ中进行深入地探讨。     

Acute uric acid nephropathy in two gouty patients with moderate hyperuricemia and high urine acidity

Summary Acute uric acid nephropathy has been described almost uniformly in patients with massive uric acid overload (malignancies with rapid cell destruction, epileptic seizures). Severe hyperuricosuria and intratubular uric acid precipitation result. Here we present two patients with gout, normal uric acid production, and moderate hyperuricemia, both of whom developed acute uric acid nephropathy. Because of pronounced urine acidity (pH values of 4.6 and 5.0 in morning fasting urines), supersaturation with respect to undissociated uric acid exceeded solubility (0.54 mmol/l), despite basal urate secretions of less than 2.2 mmol/24 hours. Additional predisposing factors, such as uricosuric treatment, heavy beer-drinking, over-consumption of purine-rich foods, and hot environment, were superimposed in both cases.Abbreviations S_Cr serum creatinine - S_UA serum uric acid - GFR glomerular filtration rate - C_Cr creatinine clearance - C_Urate urate clearance - UV_Urate urinary excretion of urate - UUA urinary undissociated uric acid - TUA urinary total uric acid - FE_Urate fractional excretion of urate     

The C677 mutation in methylene tetrahydrofolate reductase gene: correlation with uric acid and cardiovascular risk factors in elderly Korean men

The C677T mutation in the methylene tetrahydrofolate reductase (MTHFR) gene results in elevated homocysteine levels and, presumably, in increased cardiovascular risk. Moreover, elevated homocysteine levels are reportedly associated with high serum uric acid levels. We evaluated the MTHFR genotype and a panel of biochemical, hematological variables, and lifestyle characteristics in 327 elderly Korean men (age range 40-81 yr; mean, 51.87). This study shows that mutation of the MTHFR gene may be a risk for hyperuricemia. The mean uric acid levels for the C/C, C/T and T/T genotypes were 5.54, 5.91 and 6.33 mg/dL, respectively (p=0.000). The T/T genotype was significantly more frequent in subjects with high uric acid levels (p=0.003). Thus, this mutation of the MTHFR gene is implied by the study results to be a risk factor of hyperuricemia in elderly Korean men. However, the relationship between the MTHFR mutation and uric acid metabolism remains unclear. Therefore, further studies are necessary to explain the associated between the MTHFR mutation and elevated uric acid levels, and to examine potential relationships between it and conventional cardiovascular risk factors.     

Incidence,medical resource utilisation and costs of hyperuricemia and tumour lysis syndrome in patients with acute leukaemia and non-Hodgkin's lymphoma in four European countries

Hyperuricemia (HU) and tumour lysis syndrome (TLS) are complications of acute leukaemia and non-Hodgkin lymphoma (NHL) leading to increased morbidity and mortality. The objective of this study was to define incidence and calculate health care cost associated with HU and TLS. 788 acute leukaemia and NHL patients from Belgium, The Netherlands, Spain and UK were screened retrospectively for HU and TLS. Resource use related to HU and TLS was recorded and costs were calculated applying local unit costs. Results showed that HU occurred in 18.9% of patients, and 27.8% of them fulfilled TLS criteria. The cost of HU without TLS was €672 (SE 181), the cost of TLS €7,342 (SE 1,412). TLS requiring dialysis incurred an average cost of €17,706. In conclusion, it is noted that the observed incidence rates were lower than earlier reports. In addition, some risk factors for HU and TLS (e.g. paediatric patients versus adults) were not associated with increased rates of HU or TLS as a consequence of higher rates of prevention. TLS cases incurred 11 times higher costs than HU cases in which TLS was absent. The main cost drivers in TLS are interventions requiring intensive care.