【摘要】 目的 探讨无症状人群高尿酸血症与高甘油三酯血症的相关性，为临床疾病的预防和治疗提供实验基础研究。 方法 回顾分析2008年5月-2009年5月门诊体检中200名无临床症状高血尿酸者（A组）的血脂检查情况，并与同期200例血尿酸正常者（B组）的血脂检查情况进行比较分析。A组：男121例，女79例；年龄20～60岁，平均43岁。男性患者血尿酸gt;420 mmol/L，女性患者gt;360 mmol/L。 B组：男115例，女85例；年龄20～60岁，平均41岁。男性患者血尿酸为99～420 mmol /L，女性患者为99～360 mmol/L。两组性别和年龄差异无统计学意义（Pgt;0.05）。 结果 A组甘油三酯、总胆固醇、低密度脂蛋白、高密度脂蛋白分别为（3.09±0.98）、（4.05±1.07）、（3.38±0.98）、（1.30±0.51）mmol /L；B组为（1.65±0.86）、（3.99±0.99）、（2.97±0.89）、（1.41±0.66）mmol /L。 A组甘油三酯较B组比较，差异有统计学意义（Plt;0.01）；总胆固醇、低密度脂蛋白、高密度脂蛋白比较，差异无统计学意义（Pgt;0.05）。经相关性分析，A组血尿酸与甘油三酯呈正相关（r=0.69， Plt;0.01）。 结论 血尿酸代谢与甘油三酯代谢之间有一定的联系。【Abstract】 Objective To explore the correlation between hyperuricemia and hypertriglyceridemia in asymptomatic people to provide the basic information for clinical prevention and treatment. Methods The blood lipid (TG, TC, LDL, and HDL) levels in 200 asymptomatic individuals with high uric acid (A group) and 200 sex-and age-matched ones with normal serum uric acid (B group) were examined and the results of the two groups were compared. Results The concentration of triacylglycerol, total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were (3.09±0.98), (4.05±1.07), (3.38±0.98), and (1.30±0.51) mmol/L, respectively in group A; and were (1.65±0.86), (3.99±0.99), (2.97±0.89), and (1.41±0.66) mmol /L, respectively in group B. The concentration of TG in group A was obvious higher than that in group B (Plt;0.01). However, the differences of their total cholesterol, low-density lipoprotein cholesterol, and high-density lipoprotein cholesterol were not significant (Pgt;0.05). The increase of TG was obvious compared with TC(Plt;0.01), LDL (Plt;0.01), and HDL (Plt;0.01) in group A; while the comparisons in group B were not significant (Pgt;0.05). Conclusion Uric acid metabolism correlates with triacylglycerol metabolism.
Objective To study the risk factors of hyperuricemia in patients with mild coronary artery stenosis. Methods The clinical data of 267 patients, who underwent coronary angiography, were collected and classified into the hyperuricemia group (58.5±8.0 years) and the normal control group (57.3±9.9 years). The coronary artery diameter stenosis of all the patients was lower than 50%. Results Elevated levels of body mass index (BMI), serum creatinine, triglyceride, low level of high-density lipoprotein, and history of hypertension or diabetes mellitus were significantly correlated with increased prevalence of hyperuricemia in patients with mild coronary artery stenosis. Multivariate logistic regression models found that the risk factors were diabetes mellitus (OR=1.999, 95%CI 1.087 to 3.678) , BMI (OR=1.110, 95%CI 1.009 to 1.221), hypertriglyceridemia (OR=1.237, 95%CI 1.023 to 1.496), and serum creatinine (OR=1.026, 95%CI 1.008 to 1.045). Conclusion Diabetes mellitus, BMI, hypertriglyceridemia and serum creatinine are independent risk factors of hyperuricemia in patients with mild coronary artery stenosis.
Objective To provide a clinical basis for the prevention of diabetic foot ulcers by analyzing the clinical data and prognosis of high-risk diabetic foot patients. Methods A retrospective analysis was performed on high-risk diabetic foot patients who were hospitalized in West China Hospital of Sichuan University between January 1, 2012 and December 31, 2018. Patients were divided into high-risk group and low-risk group according to whether they hada history of foot ulcer or amputation. The clinical characteristics of the two groups of patients were compared. The patients were followed up from hospital discharge to January 31, 2021, and their survival and ulcer recurrence or new-onset status were evaluated. Results Finally, 123 patients were included, including 29 patients in the high-risk group and 94 patients in the low-risk group. There was no statistical difference in the duration of diabetes, smoking history, drinking history, education level, proportion of receiving regular treatment, proportion of regular blood glucose monitoring, body mass index, proportion of diabetic peripheral neuropathy, callus, foot deformity, diabetic nephropathy, diabetic retinopathy, diabetic cardiac autonomic neuropathy, diabetic gastrointestinal autonomic neuropathy, hypertension, coronary heart disease and laboratory test results between the two groups (P>0.05). The proportion of women (51.7% vs. 29.8%), age [(69.8±10.3) vs. (64.4±11.3) years], proportion of lower extremity arterial disease (62.1% vs. 34.4%), proportion of hyperuricemia (27.6% vs. 10.6%) in the high-risk group were higher than the low-risk group (P<0.05). After follow-up (67±20) months, 25.8% of the patients had ulcer recurrence or new onset, and 24.2% of the patients died. The most common cause of death was diabetes complications (43.8%). The overall 1-, 3-, and 5-year cumulative mortality rates of the patients were 4.5%, 12.7%, and 20.6%, respectively. The 3- and 5-year recurrence or new ulcer rates were 8.3% and 18.2%, respectively. The 5-year recurrence or new ulcer rates in the low-risk group and high-risk group were 10.3% and 40.3%, respectively, and there was a difference in ulcer recurrence between the two groups (P=0.004). Conclusions Compared with high-risk diabetic foot patients without ulcer or amputation, patients with a history of ulcer or amputation have higher rates of lower extremity arterial disease and hyperuricemia. Patients with a history of ulceration or amputation have a higher risk of recurrent or new ulceration than patients without a history of ulceration or amputation.
摘要:目的: 系统评价非布索坦治疗痛风的疗效及安全性。 方法 :计算机检索PubMed、EMBASE、SCI、CBM、CNKI、VIP、万方数据库及Cochrane图书馆,手工补充检索;纳入非布索坦治疗痛风的随机对照试验(RCT);进行方法学质量评价和Meta分析。 结果 :共纳入3个RCT(受试者1985例),A级文献1篇,B级文献2篇。Meta分析结果显示:最后3月血清尿酸(SU)持续低于60 mg/dl患者数、随访结束时SU低于60 mg/dl患者数非布索坦组与对照组差异均有统计学意义;治疗相关不良事件发生数与安慰剂组差异无统计学意义,与别嘌呤组差异有统计学意义。 结论 :基于当前证据,非布索坦治疗痛风,能有效降低SU含量,减少治疗相关不良事件发生率。Abstract: Objective: Assessing the effectiveness and safety of febuxostat for the treatment of gout. Methods :Randomized controlled trails(RCT) of febuxostat for the treatment of gout were gathered from the Cochrane Library、PubMed、EMBASE、SCI、CBM、CNKI、VIP、Wangfang Database, other relative researches were handsearched, each RCT was methodological quality evaluated, then analyzed by software RevMan50 Results :A total of 3 RCTs were collected (involving 1985 subjects); 1 was graded A, 2 were B; according to the Metaanalysis: the differences of subjects with last 3 monthly serum urate(SU)＜60mg/dl and subjects with SU＜60mg/dl at final visits were significant; treatmentrelated adverse events between febuxostat and allopurinol was significant different, but not significant difference between febuxostat and placebo. Conclusion : According to the evidence currently, febuxostat could reduce SU and the episodes of treatmentrelated adverse events.
Objective To assess the efficacy and safety Losartan for essential hypertension associated withhyperuricemia. Methods Included randomized controlled trials of Losartan versus Valsartan. Electronic searchconducted in CENTRAL, the Cochrane Library (until 2008, Issue 4), PubMed, EMBASE, Chinese Biomedicine database,Chinese Scientific Journals Full-text Database, and China Journal Full-text Database (until 2008, Issue 10). Two reviewers extracted data independently. RevMan 5.0 software developed by the Cochrane Collaboration was used for Metaanalysis.Results Only 7 trials with 1 136 eligible patients were included in the systematic review. Meta-analysis showedno significant difference in reductions of systolic blood pressure, diastolic blood pressure, and adverse events betweenLosartan and Valsartan groups. However, a significant difference of serum uric acid reduction was observed betweenLosartan and Valsartan group. Losartan play a significant role of decreased serum uric acid levels. Conclusions Based on this systematic review, Losartan is effective and well tolerated in reducing BP and serum uric acid levels. Further large randomized, double blind, placebo controlled trials are needed in long-term safety and efficacy and different subgroups of Losartan.
目的 探讨不同性别IgA肾病患者合并高尿酸血症的临床及肾脏病理特点。 方法 采用回顾性研究方法，将2008年1月－2010年12月收治的226例经肾活检确诊的原发性IgA肾病患者分为男性高尿酸血症组、男性尿酸正常组、女性高尿酸血症组及女性尿酸正常组4组，统计分析4组的临床指标及病理指标。 结果 高尿酸血症患病率男性（21.7%）高于女性（11.9%），差异有统计学意义（P＜0.01），尿检异常型患病率男性（14.6%）高于女性（4.0%），差异有统计学意义（P＜0.01），女性LeeⅢ级的患病率（7.1%）高于男性（5.8%），差异有统计学意义（P＜0.01）；男性高尿酸血症组的尿素氮高于尿酸正常组（P＜0.05），女性高尿酸血症组的血尿素氮、血肌酐、胱抑素C、舒张压、甘油三酯比尿酸正常者明显增高（P＜0.01），女性高尿酸血症组的高密度脂蛋白明显高于男性组（P ＜0.01）。 结论 高尿酸血症是IgA肾病的危险因素，可导致更严重的肾功能损害及肾脏病理损害，这种影响在不同性别中存在差异。
目的 观察秦绵祛风胶囊对鹌鹑高尿酸血症的影响。 方法 通过喂饲用酵母配制的造模饲料造成鹌鹑高尿酸血症模型，设秦绵祛风胶囊高、中、低3个剂量组并以苯溴马隆为阳性对照，在造模的同时连续灌胃药35 d，检测血中黄嘌呤氧化酶、尿酸、血尿素氮和三酰甘油及粪便中尿酸含量。 结果 模型动物血清中黄嘌呤氧化酶、尿酸和三酰甘油水平及粪便中尿酸含量较正常对照组明显升高。秦绵祛风胶囊各剂量组均可显著降低鹌鹑血清中的尿酸和三酰甘油水平，同时升高粪便中尿酸含量，对血清中黄嘌呤氧化酶活性影响不大。 结论 秦绵祛风胶囊具有降脂降尿酸的功能，其机制可能是通过提高动物排泄尿酸的能力，从而降低血中尿酸的含量。