中药泄浊除痹汤降低痛风患者血尿酸的作用

目的:观察中药泄浊除痹汤治疗高尿酸血症的疗效。方法:采用非盲法随机对照试验,将121例痛风高尿酸血症患者随机分入中药水煎剂组、颗粒组和苯溴马隆对照组,中药水煎剂组41例,颗粒剂组40例,苯溴马隆组40例,3组分别服泄浊除痹汤水煎剂、颗粒剂和苯溴马隆片,疗程20d。结果:3组病例治疗后10d、20d血尿酸较治疗前均明显下降(t=2.756～2.991,P<0.05),3组治疗后显效率和总有效率分别为68%和93%,75%和90%,与72%和92%,差异无统计学意义(χ2=0.02,P>0.05)。中药两组均未见不良反应。结论:中药泄浊除痹汤治疗高尿酸血症有明显效果,颗粒剂和水煎剂的效果基本相同。     

Circadian rhythm of uric acid levels of the serum in gout

Uric acid concentration in the serum was investigated 3 times a day using the uricase method in 15 gout inpatients on a hypopurine diet with age- and sex-adjusted caloric content. The highest uric acid concentration was noted at 7 a. m., the lowest concentration value at 11 p. m. The highest renal clearance values were noted from 7 a. m. till 3 p. m., the lowest ones from 11 p. m. till 7 a. m. Similar regularities were noted in 15 rheumatoid arthritic patients, however uric acid concentration in the serum was lower and its renal excretion was 1.7 times more effective.     

An enzymic assay for uric acid in serum and urine compared with HPLC

We evaluated a colorimetric method for the assay of uric acid in serum or urine, which utilises a Trinder chromogenic system modified by the inclusion of 2,4,6-tribromo-3-hydroxybenzoic acid for oxidative coupling to p-aminophenazone. Colour development (Amax: 512 nm) is complete within five minutes. Measurement of a sample blank is not needed. The procedure involves pre-incubation with ascorbic acid oxidase and detergent to eliminate interference by ascorbic acid and to abolish turbidity due to lipaemia; this pretreatment was effective up to 1.14 mmol/l ascorbate and up to at least 25 mmol/l triacylglycerol. Interference by icteric sera was insignificant up to about 170 mumol/l bilirubin. The method is linear up to at least 1428 mumol/l. In human serum and urine the procedure correlates well with HPLC and the uricase p-aminophenazone method on the SMAC analyser. Within-run and between-run imprecisions of the enzymic test were higher than for HPLC, but did not exceed 1.2% (CV) and 2.5% (CV), respectively.     

肝硬化失代偿患者血尿酸水平的变化及意义

目的探讨肝硬化失代偿患者血尿酸（UA）水平的变化及意义。方法应用酶法测定81例肝硬化失代偿患者和32例健康对照者血UA值,并计算其肾小球率过滤（GFR）。结果肝硬化失代偿组、肝功能各分级组、腹水组的UA值与健康对照组比较,均无统计学差异;肝硬化失代偿患者GFR水平分组的UA值与健康对照组比较,有统计学差异。结论肝硬化失代偿患者血尿酸水平与肝功能损害程度无明显关系,尿酸水平不能作为判断肝硬化失代偿患者腹水程度的指标,UA水平可在一定程度上反映肝硬化失代偿患者肾功能的变化。     

全身性炎症反应综合征病人血清尿酸水平及其临床意义

目的:探讨全身炎症反应综合征(SIRS)病人血清尿酸水平与患者预后的关系。方法:对42例符合SIRS诊断标准的患者,抽肘静脉血3ml用酶热量法测定尿酸,根据结果分成低尿酸组(≤295 μmol/L)、中尿酸组(296-375 μLmol/L)和高尿酸组(≥376 μmol/L),同时测定超氧化物歧化酶(SOD)和过氧化脂质(LPO)的活性,住院观察患者的预后。结果:尿酸水平与SOD、LPO呈平行关系,尿酸水平高者多器官功能障碍综合征(MODS)的发生率高。结论:尿酸水平与引起SIRS期炎性损伤的自由基有关,同时在出现SIRS的早期根据尿酸水平的高低判断患者的预后,并采取有效的治疗措施,减少MODS的发生,提高治愈率。     

Deproteinizing methods evaluated for determination of uric acid in serum by reversed-phase liquid chromatography with ultraviolet detection

We evaluated six deproteinizing methods for determination of uric acid in serum by "high-performance" liquid chromatography with ultraviolet detection: those involving zinc hydroxide, sodium tungstate, trichloroacetic acid, perchloric acid, acetonitrile, and centrifugal ultrafiltration (with Amicon MPS-1 devices). We used a Toyosoda ODS-120A reversed-phase column. The mobile phase was sodium phosphate buffer (40 mmol/L, pH 2.2) containing 20 mL of methanol per liter. Absorbance of the eluate was monitored at 284 nm. The precipitation method with perchloric acid gave high recoveries of uric acid and good precision, and results agreed with those by the uricase-catalase method of Kageyama (Clin Chim Acta 1971;31:421-6).     

Washed microbiota transplantation reduces serum uric acid levels in patients with hyperuricaemia

BACKGROUNDPrevious studies have found that hyperuricaemia (HUA) is closely related to intestinal flora imbalance.AIMThe current study investigated the effects and safety of washed microbiota transplantation (WMT) on serum uric acid (SUA) levels in different populations.METHODSA total of 144 patients who received WMT from July 2016 to April 2020 in the First Affiliated Hospital of Guangdong Pharmaceutical University and had SUA data before treatment were selected. Changes in SUA levels before and after treatment were retrospectively reviewed based on short-term and mid-term effects of WMT regimens. SUA levels measured in the last test within 3 mo after the first WMT represented the short-term effect, and SUA levels measured in the last test within 3-6 mo after the first WMT represented the mid-term effect. The patients were divided into an HUA group (SUA > 416 μM) and a normal uric acid (NUA) group (SUA ≥ 202 μM to ≤ 416 μM) based on pretreatment SUA levels.RESULTSAverage short-term SUA levels in the HUA group decreased after WMT (481.00 ± 99.85 vs 546.81 ± 109.64 μM, n = 32, P < 0.05) in 25/32 patients and returned to normal in 10/32 patients. The short-term level of SUA reduction after treatment moderately correlated with SUA levels before treatment (r = 0.549, R² = 0.300, P < 0.05). Average SUA levels decreased after the first and second courses of WMT (469.74 ± 97.68 vs 540.00 ± 107.16 μM, n = 35, and 465.57 ± 88.88 vs 513.19 ± 78.14 μM, n = 21, P < 0.05). Short-term and mid-term SUA levels after WMT and SUA levels after the first, second and third courses of WMT were similar to the levels before WMT in the NUA group (P > 0.05). Only 1/144 patients developed mild diarrhea after WMT.CONCLUSIONWMT reduces short-term SUA levels in patients with HUA with mild side effects but has no obvious effect on SUA levels in patients with NUA.     

血尿酸在急性ST段抬高心肌梗死患者的临床价值

目的 探讨不同血尿酸水平对急性ST段抬高心肌梗死患者的临床意义.方法 回顾性分析2005年1月至2010年12月北京中日友好医院收治的502例急性ST段抬高心肌梗死患者的临床资料,根据血尿酸水平分为高尿酸血症组(119例)和正常血尿酸组(383例),比较两组患者的血脂水平,超声心动图检查结果和住院期间的主要心血管不良事件.同时根据冠状动脉造影结果分析血尿酸水平与冠状动脉病变程度的关系.应用SPSS 17.0统计软件,数据分析采用t检验、x2检验和Pearson相关性检验.结果 血尿酸水平与甘油三酯水平呈正相关(r=0.11,P=0.018),在急性ST段抬高心肌梗死患者,高尿酸血症组高脂血症多见(43.7％ vs.33.7％,P=0.047),甘油三酯水平显著高于正常血尿酸组[(2.11±1.24)mmol/L vs.(1.78±1.38)mmol/L,P=0.014].血尿酸水平在不同冠状动脉病变支数组之间差异无统计学意义(P≥0.05).超声心动图检查发现高尿酸血症组左室舒张末径显著大于正常血尿酸组[(53.52 ±6.19)mmvs.(52.18±4.89)mm,P=0.041],左室收缩功能、舒张功能减低的发生率显著增加(36.4％ vs.15.1％,P＜0.01; 68.2％ vs.55.8％,P=0.023).搞尿酸血症组住院期间主要心血管不良事件的发生率显著高于正常血尿酸组(P＜0.05).结论 血尿酸水平与甘油三酯水平密切正相关,与冠状动脉病变严重程度无明显相关.在急性ST段抬高心肌梗死患者,高尿酸血症组左室收缩、舒张功能减低的发生率增加,主要心血管不良事件的发生率增加.     

亚临床甲状腺功能减退对2型糖尿病患者血尿酸水平的影响

目的探讨亚临床甲状腺功能减退(SCH)对2型糖尿病(T2DM)患者血尿酸水平以及相关指标的影响。方法回顾性分析872例2型糖尿病患者病例资料,根据血促甲状腺激素(TSH)水平分为SCH组(102例)、甲状腺功能正常组(770例)。收集两组患者临床资料、甲状腺功能、血尿酸及其他生化指标。比较两组血尿酸的差异并分析血尿酸与其他指标的关系。结果 (1)与甲状腺功能正常组相比,SCH组病程、年龄、体质量指数(BMI)、尿酸(SUA)、三酰甘油(TG)、总胆固醇(TC)、低密度脂蛋白胆固醇(LDL-C)、甲状腺过氧化物酶抗体(TPOAb)、甲状腺球蛋白抗体(TGAb)水平均升高,而空腹血糖(FPG)、糖化血红蛋白(Hb A1c)、游离甲状腺素(FT4)水平降低,差异有统计学意义(P0.05)。而游离三碘甲状腺原氨酸(FT3)、高密度脂蛋白胆固醇(HDL-C)差异无统计学意义(P0.05)。(2)Pearson相关性分析显示,TSH与血清尿酸(SUA)、病程、BMI、TG、TC、LDL-C、TPOAb、TGAb呈显著正相关,而与FPG、Hb A1c和FT4呈显著负相关。(3)在调整年龄、性别、病程、BMI、TG、TC、LDL-C、FBG、FT4和TSH等指标后,多元逐步线性回归提示,SUA与年龄、TG、FT4、TSH密切相关。结论 SCH是2型糖尿病患者高尿酸血症的独立危险因素。     

慢性心力衰竭患者血清尿酸水平变化及临床意义

目的探讨慢性心力衰竭患者血清尿酸的变化及临床意义。方法选择300例慢性心力衰竭患者为研究组及180例心功能正常者为对照组。测定血清尿酸及血脂等指标，同时应用超声心动图测定左心室射血分数、左心室收缩末期内径、左心室舒张末期内径、每搏输出量、心排血量。结果血清尿酸水平与．心功能分级相关，合并高尿酸血症的慢性心力衰竭患者室性心律失常的发生率增加。结论血清尿酸水平与慢性心力衰竭的心功能分级相关，可能是慢性心力衰竭判定预后的预测因子。     

血尿酸水平与新发心血管疾病及糖尿病肾病的相关性

目的探讨Ⅱ型糖尿病患者血尿酸水平与新发心血管疾病及糖尿病肾病的相关性。方法筛选西安市中心医院2014年11月~2016年11月280例糖尿病患者,以血尿酸水平为基准分为高尿酸组和正常尿酸组,各140例,检测两组患者心血管相关指标和肾损害指标,评价血尿酸水平与新发心血管疾病及糖尿病肾病的关系。结果高尿酸组患者的颈动脉内-中膜厚度、尿白蛋白/肌酐比值及甘三油酯高于正常尿酸组,差异有统计学意义（P<0.01）;高尿酸组高血压、冠状动脉粥样硬化及糖尿病肾病的发生率高于正常尿酸组（P<0.05）;高尿酸组冠状动脉粥样硬化和糖尿病肾病的发生时间分别为12.58±2.36月和11.75±1.96月,短于正常尿酸组（P<0.05）;多元回归分析显示血尿酸水平是颈动脉内-中膜厚度、尿白蛋白/肌酐比值的主要影响因素。结论Ⅱ型糖尿病患者血尿酸水平与新发心血管疾病及糖尿病肾病呈正相关,随着血尿酸水平升高新发心血管疾病及糖尿病肾病的概率更高、发病时间更早。     

血清尿酸水平对脑卒中患者预后影响的探讨

目的 探讨血清尿酸（uric acid,UA）水平对脑卒中患者预后评估的临床价值.方法 以1332例脑卒中患者为研究对象,按照疾病的类型和UA水平分为出血性脑卒中低UA组（A组）124例,出血性高UA组（B组）28例,梗死性低UA组（C组）1039例和梗死性高UA组（D组）141例.收集所有患者的血压、年龄、血清UA、血脂、血糖、WBC、血红蛋白、纤维蛋白原水平和住院天数等临床基本资料,并进行统计学分析.采用COX回归风险模型对患者预后进行生存分析,组间生存曲线的比较使用Ka-plan-Meier法,并用对数秩和分析进行组间比较.结果 临床资料分析中,A组和B组患者的年龄、痛风、蛋白尿、肌酐、UA、胆固醇、低密度脂蛋白胆固醇（low density lipoprotein cholesterol,LDL-C）经比较差异均有统计学意义（P均＜ 0.05）;C组和D组患者的舒张压、糖尿病、痛风、卒中史、蛋白尿、肌酐、UA、胆固醇、甘油三酯、LDL-C和WBC经比较差异亦均有统计学意义（P均＜0.05）.COX回归分析中,高尿酸血症与发生终点事件的相对危险度为1.004 （P=0.000）.梗死性脑卒中患者中,低UA发生终点事件的概率为20.3％,高UA为34.0％,两组差异有统计学意义（P＜0.05）.结论 血清UA水平与出血性脑卒中患者的预后无明显关系,而与梗死性脑卒中患者的预后密切相关.血清UA可作为梗死性脑卒中患者再发卒中的独立危险因素.     

血清尿酸紫外分光光度参考方法的建立及性能评价

目的以尿酸酶紫外光度法为基础,建立血清中尿酸测定的参考方法并评价其性能.方法 用新鲜患者血清样本、迈瑞常规复合校准品等对方法的精密度进行评估;用有证参考物质SRM909bⅠ和Ⅱ、IFCC参考实验室质评样本Rela A/B对方法的准确度进行初步评价,同时测定新鲜人血清并与同位素稀释质谱法进行方法学对比,验证方法准确度.结果 方法对新鲜患者血清、厂家复合校准品等不同类型样本批内不精密度CVintra小于1%,总不精密度CVt小于2%;有证参考物质SRM909bⅠ/Ⅱ测定结果均在参考值范围内,对UA参考实验室能力验证样本Rela A/B测定结果与中心值结果相对偏差小于0.5%;血清样本测定结果与同位素稀释液相质谱法可比,线性回归斜率1.005,相关系数0.999,医学决定水平处引入的相对误差小于3.25%.结论 血清尿酸紫外分光光度法已基本建立,精密度和准确度符合要求,测量结果和同位素稀释液相色谱/质谱法可比,可为常规系统尿酸溯源体系的建立和性能评估提供便捷有效的方法.