高尿酸血症防治中应关注的几个关键问题

随着人们生活水平的提高和饮食结构的改变,高尿酸血症及其相关疾病的发病率急剧上升.由于多数患者处于无症状高尿酸血症状态,故尚未引起患者和医务工作者的重视.本文就高尿酸血症与痛风、肾损害、糖代谢紊乱、动脉粥样硬化性疾病的关系及其预防进行评论,以期提高广大临床医师对高尿酸血症的认识及对该病防治的重视.

Abstract：

The incidence of hyperuricemia and relevant diseases has been increasing recently since the living improvement and dietary changing. Both patients and doctors do not pay enough attention to this disease, due to the lack of obvious clinical presentations in early stage. This paper comments on the relationship between hyperuricemia and gout, gouty nephropathy, impaired glucose metabolism,and atherosclerotic diseases in order to arouse enough attention to this disease.     

山东沿海居民高尿酸血症及痛风五年随访研究

目的 与2004年结果相比较,明确目前山东沿海地区20岁以上居民高尿酸血症(HUA)与痛风的患病情况及其影响因素.方法 采用随机(随机数字表法)、分层、整群抽样的方法,入户调查青岛、烟台、威海、日照、东营5 191名长住居民HUA与痛风的患病情况.结果 (1)与2004年相比,2009年无论男性还是女性,人群整体血尿酸水平均有增高趋势.(2)按照统一人口标化后,2009年HUA患病标化率为16.99%,比2004年增加3.72%;其中男性增加4.57%、女性增加3.33%.(3)痛风患病标化率为1.36%,比2004年增加0.26%;其中男性降低0.45%,女性增加0.85%.(4)与2004年比较,目前30岁以下男性人群的HUA患病率最高,50~岁年龄组为最低.同样30岁以下女性人群中HUA患病率也较2004年明显增高,70~岁患病率最高.(5)与2004年相比,男性痛风患病率40~岁年龄组为最高.女性30岁以下年龄组较2004年明显增加,70~岁患病率最高.(6)logistic回归分析显示每日海产品摄入量、肉类产品摄入量、啤酒和烈酒摄入量均为HUA和痛风独立危险因素.结论 与2004年相比,人群整体血尿酸水平、HUA和痛风患病率均有增高趋势,且呈明显年轻化,以女性增加显著;膳食因素对HUA和痛风发病有明显影响,海产品、肉类产品、啤酒和白酒每日摄入量为HUA独立危险因素.

Abstract：

Objective To determine the prevalence and risk factors of hyperuricemia (HUA) and gout among residents aged≥20 years in Shandong coastal areas compared with the results of 2004. Methods A randomized stratified cluster sampling was conducted, and 5 191 inhabitants were investigated for prevalences of HUA and gout in Qingdao, Yantai, Weihai, Rizhao, and Dongying. Results (1)The level of serum uric acid had the tendency to increase in both males and females in 2009 compared with that in 2004. (2)According to the uniform population standardization, the standardized prevalence of HUA was 16.99%in 2009. The standardized rate increased by 3.72%compared to 2004, being 4.57%in males and 3.33%in females. (3) The standardized prevalence of gout was 1.36%. Compared with that in 2004, the standardized rate increased by 0.26%, decreased by 0.45%in males while increased by 0.85%in females. (4) Compared to 2004, the prevalence of HUA among males aged≤30 years was the highest, whereas aged between 50 years and 60 years was the lowest at present. (5) Currently, the prevalence of HUA among females aged≤30 years was significantly higher than that of 2004, and aged≥70 years was the highest. (6) Logistic regression analysis showed that the amount of daily intake of seafood, meat, beer, and liquor were independent risk factors of HUA and gout. Conclusions Compared to 2004, the level of serum uric acid and the prevalence of HUA and gout show a tendency to increase among younger in the population surveyed in 2009, significant in female. Dietary factors exert significant effects on the development of HUA and gout. The amount of daily intake of seafood, meat, beer, and liquor are independent risk factors of HUA and gout.     

高尿酸血症与心血管疾病关系的研究进展

大量研究已证实高尿酸血症与心血管疾病相关.尿酸代谢受饮食、药物、机体内环境等诸多因素的影响,其与心血管疾病的关联目前尚未完全清楚,本文就近年来高尿酸血症与心血管疾病相关性的流行病学及发病机制研究进展进行综述.

Abstract：

Lots of studies have identified the relationship between hyperuricemia and cardiovascular diseases. Many factors affect the metabolism of uric acid, such as diet, drug, internal environment of organism, etc. However, the relationship between hyperuricemia and cardiovascular diseases is not quite clear. In this review, we present recently published data about the association between hyperuricemia and selected cardiovascular diseases.     

痛风饮食10误区

“如何饮食”是痛风患者最为关心的话题,合理的饮食能有利于患者药物治疗的疗效和控制痛风急性发作,不合理的饮食则会使患者的病情雪上加霜.但是许多患者会“道听途说”,在认识上产生许多饮食误区,总结如下,可供参考.     

极低密度脂蛋白对HK-2细胞hUAT基因表达的影响

 目的 观察不同浓度极低密度脂蛋白（VLDL）是否调节肾小管上皮细胞（HK-2细胞）人尿酸盐转运子（hUAT）mRNA的表达。方法 根据培养液中所含VLDL浓度的不同，将HK-2细胞分为：①仅使用DMEM/F-12组（对照组）；②DMEM/F-12+ 50 μg/ml VLDL组（V1组）；③DMEM/F-12+100 μg/ml VLDL组（V2组）；④DMEM/F-12+200 μg/ml VLDL组（V3组）；⑤DMEM/F-12+400 μg/ml VLDL组（V4组）。每组均培养 6瓶细胞。上述细胞在不同培养液中分别培养48 h。采用实时荧光定量PCR检测HK-2细胞中hUAT mRNA的相对表达量（2^ΔΔCt法）。结果 所有标本均能检测到hUAT mRNA的表达，但V1～V4组hUAT mRNA表达水平均明显低于对照组，其中，VLDL最低浓度（50 μg/ml）组hUAT mRNA表达水平为对照组的64%，VLDL最高浓度（400 μg/ml）组hUAT mRNA表达水平仅为对照组的24%。结论 VLDL下调hUAT mRNA表达，VLDL的这种作用可能与脂代谢紊乱易合并高尿酸血症有关。     

下颌骨造釉细胞瘤合并涎腺肿瘤

虽然有不少文献报道造釉细胞瘤,但造釉细胞瘤和其他肿瘤同时发生报道不多。本文两例下颌骨造釉细胞瘤,其中1例合并颌下腺腺泡细胞瘤,另1例合并腮腺腺淋巴瘤。     

445例口腔颌面部恶性肿瘤临床分析

口腔颌面部恶性肿瘤发病率较高,约占全身恶性肿瘤的1O%。在口腔颌面部肿瘤中恶性肿瘤约占30%;其中口腔癌约占全身恶性肿瘤的3%,多数为鳞状细胞瘤。现临床分析如下。     

新型冠状病毒灭活疫苗抗原含量检测能力验证

目的 开展新型冠状病毒灭活疫苗抗原含量检测能力验证,对参加实验室检测能力进行评价。方法 对能力验证用新型冠状病毒灭活疫苗样品进行均匀性和稳定性检验,采用冷链运输方式将新型冠状病毒灭活疫苗样品、参考品及检测试剂盒分发至各参加实验室。考察鉴别试验、抗原含量检测和实验室内变异3项指标。结果 能力验证样品的均匀性和稳定性符合要求,共有14家实验室参加本次能力验证并按要求报告结果,各实验室3项指标考核结果均为满意。结论 参加本次能力验证的我国省级药检机构及灭活疫苗生产企业具有较好的新型冠状病毒灭活疫苗检测能力和质控水平。     

老年冠心病合并糖尿病患者中冠状动脉病变的特点

1　资料与方法本研究共统计 32 6例老年冠心病患者 ,将 133例 6 5岁以上冠心病患者分为冠心病合并糖尿病组 (ＤＭ组 ) 6 5例和单纯冠心病组 (ＣＨＤ组 ) 6 8例。全部病例均行ＣＡＧ和口服 75ｇ葡萄糖耐量试验 ,测定空腹血糖、胰岛素、糖化血红蛋白(ＨｂＡ1ｃ)、总胆固醇 (ＴＣ)、甘油三酯 (ＴＧ)、高密度脂蛋白 胆固醇 (ＨＤＬ Ｃ)、及餐后 2ｈ血糖、胰岛素水平。冠状动脉病变程度以美国心脏病学会 (ＡＨＡ)中狭窄的机能分类分为 6段进行评分 ,99%～ 10 0 % :5分 ;90 % :4分 ;75 % :3分 ;5 0 % :2分 ;2 5 % :1分 ;0 % :0分。分别将左冠状动…     

糖尿病肾病的分子遗传学研究进展

遗传因素在糖尿病肾病 (DN)的发生发展中起关键作用。目前认为DN的遗传模式主要有主效、中效和微效基因作用模式 3种。寻找易感基因的方法有基因连锁分析及遗传关联研究。应用这些遗传学分析方法人们发现 7q35区等染色体区域和肾素血管紧张素转化酶基因等多个遗传位点与DN的发生有关。