Objective To assess the effectiveness and safety of irbesartan for hypertensive patients with hyperuricaemia. Methods The databases such as The Cochrane Library (Issue 2, 2010), MEDLINE (by the end of April 2010), SCI (by the end of April 2010), CBM (by the end of April 2010) and CNKI (by the end of April 2010) were searched to collected randomized controlled trails (RCTs) on irbesartan for hypertensive combined with hyperuricaemia. Studies were screened according to the inclusion and exclusion criteria; data were extracted; the methodological quality was evaluated; and meta-analyses were conducted by using RevMan 5.0.0 software. Results Nine studies involving 977 patients were included. The results of meta-analyses showed that compared with the control group, irbesartan was superior in decreasing serum uric acid (SUA) (MD=57.12, 95%CI 16.08 to 98.15, P=0.006); it was similar in controlling blood pressure (Systolic pressure: MD= –0.24, 95%CI –2.19 to 1.71, P=0.81; Diastolic pressure: MD=0.46, 95%CI –1.58 to 2.50, P=0.66), and lower in the incidence rate of adverse reaction (RR=0.07, 95%CI 0.02 to 0.24, P=0.000 1). Conclusion The study suggests that irbesartan is effective and safe to control blood pressure and decrease serum uric acid for hypertensive patients with hyperuricaemia. But because all nine included studies are graded C in quality, the conclusion still needs to be further verified by long-term, large scale and high quality studies.
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。
Aippuric acid test(HAT) and hepatic energy metabolism and mitochondrial oxidative phosphorylation activity in rabbit with acute obstractive jaunidce was studied.The result showed that the HAT values were decreased from 98.4±32.0mg/h to 32.7±17.6mg/h(Plt;0.001),energy charge(EC) decreased from 0.81±0.01 to 0.72±0.02(Plt;0.001),and phosphorylation rate(PR)decreased from 62.1V5.1 to 38.3V2.4(Plt;0.001).Correlation coefficients between HAT and EC was 0.786,(Plt;0.001).This result suggests that HAT can be used as an indicator of hepatic energy metabolism status in acute obstructive jaundice.
【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.
Uric acid (UA) is the final product of human purine metabolism. As one of the main antioxidants in the body, it can scavenge oxidative radicals. Under the action of oxidative-antioxidant shuttle mechanism, the antioxidant activity of UA can be reversed, causing inflammation and oxidative stress of vascular endothelial cells. Hyperuricemia (HUA) is considered to be one of the major risk factors for diabetes and diabetic nephropathy. The study of HUA in diabetic retinopathy (DR) is also a hot topic. UA can cause retinal vascular sclerosis, and affect the occurrence and development of DR by promoting oxidative stress and inducing neovascularization.
As the largest ecosystem of human body, intestinal microorganisms participate in the synthesis and metabolism of uric acid. Developing and utilizing intestinal bacteria to degrade uric acid might provide new ideas for the treatment of hyperuricemia. The fecal samples of people with low uric acid were inoculated into uric acid selective medium with the concentration of 1.5 mmol/L for preliminary screening, and the initially screened strains that may have degradation ability were domesticated by concentration gradient method, and the strains with high uric acid degradation rate were identified by 16S rRNA sequencing method. A strain of high-efficiency uric acid degrading bacteria was screened and domesticated from the feces of people with low uric acid. The degradation rate of uric acid could reach 50.2%. It was identified as Escherichia coli. The isolation and domestication of high efficient uric acid degrading strains can not only provide scientific basis for the study of the mechanism of intestinal microbial degradation of uric acid, but also reserve biological strains for the treatment of hyperuricemia and gout in the future.
目的 探讨成都地区高尿酸血症发生的危险因素。 方法 收集2009年10月－2010年4月在四川大学华西医院体检中心进行健康体检的36 639人的临床资料，对资料进行单因素分析和多因素logistic回归分析。 结果 进行健康体检的36 639人，其中男21 175人，女15 464人。高尿酸血症患者5 233例，患病率为14.3%。年龄＞50岁、男性、饮酒、糖尿病、高血压病、甘油三酯增高、低密度脂蛋白增高和血清肌酐水平增高与高尿酸血症的发生有关。Logistic回归分析显示男性（OR=13.300，P=0.000）、饮酒（OR=4.219，P=0.009）、糖尿病（OR=3.609，P=0.024）是发生高尿酸血症独立危险因素。 结论 成都地区高尿酸血症的患病率略高于全国平均水平，临床治疗和护理高尿酸血症的患者时应积极控制与高尿酸血症发生密切相关的危险因素。
Hyperuricemia is a risk factor for various diseases, but knowledge on acute hyperuricemia is still not sufficient. The present study was aimed to investigate the effect of acute hyperuricemia on red blood cells from hemorheological point of view, and to provide the reference for clinical treatment. The rats were gavaged with 500 mg/kg hypoxanthine and intraperitoneally injected with 100 mg/kg oxonate to induce the model of acute hyperuricemia. The same volume of blood samples were drawn within time period of 0, 1, 2, 3 and 6 h, respectively, from the inner canthus of rats to measure the serum uric acid, hemorheological parameters and the malondialdehyde level. It was found that in each period of 1, 2 and 3 h, the rats had significantly higher levels of uric acid. The integrated deformation index and relax index were increased. The hemolysis rate was significantly reduced. The plasma malondialdehyde level was obviously decreased at the end of 2 h. The results suggested that short-term elevated uric acid could improve the hemorheological parameters and the lipid oxidative level in red blood cells.