吲达帕胺致低钾血症

1　病例资料【例 1】　女 ,5 2岁。因高血压病服用吲达帕胺片2 5mg ,每日 1次 ,已服 3年。近 3个月双下肢乏力 ,加重 1天来诊。查体 :血压 14 0 / 90mmHg。意识清 ,心率 80 /min ,律齐 ,听诊未闻及杂音 ,双下肢腱反射减弱。急查血钾 2 76mmol/L ,钠 138 5mmol/L ,氯10 0 9mm     

吲达帕胺和氨氯地平对血尿酸的影响

目的：探讨吲达帕胺和氨氯地平在治疗高血压病中对血尿酸的影响。方法：２６３例高血压病人共分成两组,分别行吲哒帕胺和氨氯地平降压治疗,用药半年后测定血尿酸。结果：吲达帕胺组血尿酸比氨氯地平组明显升高,百分率分别为４２．２２％和２１．０９％,两组经检验后,差异有统计学意义（Ｐ〈０．０１）。结论：吲哒帕胺治疗高血压病时,血尿酸会明显升高,故对心肾功能不全及痛风患者需慎用,氨氯地平对血尿酸影响较小,相对较安全。     

吲达帕胺致严重电解质紊乱一例

1 病例资料 男,74岁.因反复头晕不适50年,再发3天人院.患者50年前发现高血压,长期口服依那普利,10 mg/d.入院前5天自行改口服吲达帕胺,2.5 rag/d,2天后头晕加重,自觉头重脚轻,自测血压180/90 mmHg.入院时诉轻度头晕,查体神经系统无异常体征,无精神症状.     

吲达帕胺致不良反应1例

1病历摘要 女，65岁。因患高血压服用吲达帕胺片（天津力生制药有限公司生产，批号0704035）1片，1次／d。服药后约1h患者开始自觉面部发热，2h后恢复正常，第2天继续用药，服药后症状加重出现面部潮红，比第1天维持时间更长，遂来我院就诊。查体：体温正常，血压和心率未见异常，身体其他部位没有变化。因其在服药期间未再服用其他药物，故考虑为吲达帕胺致不良反应，给予10％葡萄糖酸钙注射液10ml＋25％葡萄糖注射液20ml静推，面部潮红逐渐消失。随后嘱其停药，停药后未在出现该症状。     

吲达帕胺的临床应用及不良反应

本文探讨吲达帕胺片联合用药对高血压患者的降压效果及该药的不良反应与防治。     

吲达帕胺致电解质紊乱1例

1病历摘要女,54岁。因咳嗽1周入院。患者1周前无诱因出现咳嗽,咳少量黄痰,无发热,无其他不适,自服阿莫西林2 d无好转,并感乏力,下肢无力尤其明显,故入院诊治。既往健康状况良好,发现血压升高约1 a,近5个多月服用吲达帕胺治疗,2.5 mg/     

Effect of azlocillin on uric acid levels in serum.

Uric acid levels in serum were observed to fall precipitously in a group of 20 hospitalized asthmatic patients receiving azlocillin, bronchodilators, and steroids. None of the 20 hospitalized controls receiving the antiasthma therapy without azlocillin showed any decline in their uric acid levels. The levels for the azlocillin-treated group fell from a mean of 6.4 mg/dl to mean of 2.3 mg/dl, whereas those for the control group initially were 7.0 mg/dl and fell only to a mean of 6.5 mg/dl.     

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.     

Critical evaluation of serum uric acid levels in acute myocardial infarction

Serial measurements of serum uric acid were performed on patients suffering from acute myocardial infarction. Nearly 80 percent of the cases demonstrated a fall in uric acid concentrations during the first two days of hospitalization and a subsequent return to initial levels within six to eight days. There was a relationship between the decrease in uric acid levels and the serum lactate dehydrogenase activity.No evidence could be found that male patients were hyperuricemic as compared to control subjects. However, female patients between 40 and 60 years of age demonstrated significantly higher uric acid levels than healthy women of corresponding ages, even after adjustment for diuretic use.     

血尿酸水平与帕金森病病情分级的相关性研究

目的 探讨血尿酸水平与帕金森病临床分期、认知功能损害的关系.方法 对符合入选标准的帕金森病患者作为帕金森病组(60例),登记病史及进行详细查体,测定UPDRSⅢ量表,进行Hoehn-Yahr分期及简易智能状态评分(MMSE)量表测定;同时收集与帕金森病组年龄、性别、教育程度等相匹配的同期健康体检者作为对照组(52名).两组均测定空腹血尿酸,对结果进行相应的统计学分析.结果 帕金森病组血尿酸水平明显低于对照组[(262.4 ±85.2) μmol/L和(357.6 ±73.3) μmol/L](t=1.013,P=0.00S);帕金森病患者Hoehn-Yahr分期各期之间的血尿酸水平相比较分析无等级相关性(r=0.143,P＞0.05);各期帕金森病患者的血尿酸水平比较差异无统计学意义(F=1.014,P=0.064);帕金森病组与对照组MMSE分值比较差别无统计学意义(26.12±2.87及28.32±2.17)(t=1.970,P=0.073).结论 帕金森病患者血尿酸水平降低很可能为帕金森病的危险因素之一.但不可以用来评定疾病严重程度.MMSE对于判定帕金森病认知功能损害不够敏感.     

High-dose methylprednisolone therapy in multiple sclerosis increases serum uric acid levels.

Uric acid, which is the final product of purine nucleoside metabolism, is a strong peroxynitrite scavenger. Several studies report on lower serum uric acid levels in multiple sclerosis. In this study, we investigated serum uric acid levels before and after high-dose methylprednisolone treatment (intravenous 1 g/day/5 days) in multiple sclerosis patients. Blood samples from 25 definite multiple sclerosis patients (11 male and 14 female) before and after methylprednisolone treatment (days 0, 6 and 30) and from 20 healthy donors (9 male and 11 female) were analyzed. Serum uric acid levels were measured using a quantitative enzymatic assay (Elitech diagnostics, Sees, France) according to the manufacturer's protocol, and the results were standardized using a commercial uric acid standard solution. We observed significantly increased serum uric acid levels 1 day after the termination of the therapy (day 6). These differences were sustained for 30 days after starting treatment (during remission period). Mean serum uric acid levels were significantly higher in the control group. These results suggest that increasing the uric acid concentration may represent one of the possible mechanisms of action of methylprednisolone in multiple sclerosis.     

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.     

血清胆红素和尿酸水平与冠心病的关系

目的探讨血清胆红素(Bil)和尿酸(UA)水平与冠心病(CHD)的关系。方法符合条件并经冠状动脉造影确诊的100例CHD患者为CHD组,经体检证实为健康者60名为对照组,采用全自动生化分析仪检测空腹血清总Bil(TBil)、直接Bil(DBil)和血UA浓度并计算间接Bil(IBil)。再将CHD组分为单支病变组和多支病变组与对照组进行比较,并根据冠状动脉病变积分进行统计学分析。结果CHD组血清TBil、DBil、IBil、UA与健康对照组之间的差异有统计学意义(P<0.01)。对照组、单支病变组与多支病变组之间血清Bil和UA的差异有统计学意义(P<0.05、P<0.01)。血清TBil浓度与冠状动脉病变程度呈显著负相关,而血UA与冠状动脉病变程度呈显著正相关。结论低血清Bil水平可能是CHD的危险因素之一。高UA水平可能是导致CHD的重要因素。血清Bil和UA水平与冠状动脉病变的严重程度有一定的关系,可通过血清Bil、血UA等生化指标的综合测定来间接评估患者冠状动脉病变的严重程度。     

高尿酸血症患者血尿酸与血清HGPRT、VitC水平的相关性

目的:探讨高尿酸血症(hyperuricemia,HUA)的危险因素,为有效控制血尿酸(serum uric acid,SUA)提供依据。方法:2015年1月至12月每3个月从上海市4家医院的体检人群中筛选一批SUA≥420μmol/L的受试者,共筛选出受试者144例。入组时,对所有受试者复测SUA浓度,将SUA异常者(SUA≥420μmol/L)94例作为HUA组,SUA正常者(SUA420μmol/L)50例作为SUA正常组。对所有受试者进行问卷调查、人体参数测量及血生化指标检测。结果:男性SUA浓度显著高于女性(P0.001);饮酒者SUA浓度显著高于不饮酒者(P=0.01);经常运动者SUA浓度明显低于不经常运动者(P=0.004)。收缩压与SUA浓度正相关(r=0.166,P=0.047),谷类摄入量(r=-0.215,P=0.010)、血清维生素C(vitamin C,VitC)浓度(r=-0.294,P0.001)和血清次黄嘌呤-鸟嘌呤磷酸核糖转移酶(hypoxanthine-guanine phosphoribosyl transferase,HGPRT)活性(r=-0.236,P=0.004)与SUA浓度负相关。SUA线性回归方程是,SUA=452.87(μmol/L)+1.598×收缩压(mmHg)-0.409×谷类摄入量(g)-2.231×血清VitC(mmol/L)-0.162×HGPRT(mmol/L)。结论:谷类摄入、血清VitC和HGPRT是HUA的保护因素,收缩压是HUA的危险因素;建议HUA者(尤其是男性)应在均衡营养的基础上保证谷类摄入,增加VitC摄入,戒酒,坚持运动,并积极控制收缩压。     

血清胆红素和尿酸水平与冠心病的关系

目的探讨血清胆红素（Bil）和尿酸（UA）水平与冠心病（CHD）的关系。方法符合条件并经冠状动脉造影确诊的100例CHD患者为CHD组,经体检证实为健康者60名为对照组,采用全自动生化分析仪检测空腹血清总Bil（TBil）、直接Bil（DBil）和血UA浓度并计算间接Bil（IBil）。再将CHD组分为单支病变组和多支病变组与对照组进行比较,并根据冠状动脉病变积分进行统计学分析。结果CHD组血清TBil、DBil、IBil、UA与健康对照组之间的差异有统计学意义（P〈0.01）。对照组、单支病变组与多支病变组之间血清Bil和UA的差异有统计学意义（P〈0.05、P〈0.01）。血清TBil浓度与冠状动脉病变程度呈显著负相关,而血UA与冠状动脉病变程度呈显著正相关。结论低血清Bil水平可能是CHD的危险因素之一。高UA水平可能是导致CHD的重要因素。血清Bil和UA水平与冠状动脉病变的严重程度有一定的关系,可通过血清Bil、血UA等生化指标的综合测定来间接评估患者冠状动脉病变的严重程度。