冠心病患者肠道对尿酸代谢的活性分析

目的:探讨冠心病患者肠道对尿酸的清除作用，探讨该类患者血尿酸代谢异常的可能机制。方法: 入选符合纳入标准的正常对照组40例、冠心病患者30例（伴血尿酸增高者15例和血尿酸水平正常者15例），收集所有受试者相关的血液学指标，并用酶比色法在体外检测其大便中的尿酸含量。结果: 1 g大便内的细菌分解的尿酸量:血尿酸水平正常的冠心病患者显著高于正常对照（P<0.05）；伴血尿酸水平增高的冠心病患者亦高于正常对照但无统计学差异； 冠心病两亚组间相比没有统计学差异。血脂:冠心病患者的血三酰甘油显著高于正常人（P<0.05）；高密度脂蛋白胆固醇显著低于正常对照（P<0.01）。血清内的总胆红素:冠心病患者血清中总胆红素水平低于正常对照组（P<0.05）。结论: 冠心病患者的肠道对尿酸的代谢活性高于正常人，肠道在冠心病患者血尿酸的代谢异常中发挥着重要的作用，冠心病患者的抗氧化能力较正常人降低。

Uricolysis of gut in patients with coronary heart disease

AIM: To evaluate uricolysis of gut in patients with coronary heart disease(CHD) and to discuss the underlying mechanisms for the disturbance of uric acid from the perspective of the gut.METHODS: A total of 70 subjects provided informed consent and were recruited into the study.Forty subjects were normal and 30 were subjects with established CHD(15 with elevated serum uric acid and 15 with normal level of serum uric acid).Enzyme colorimetric method was used to detect uric acid in feces,and routine laboratory indicators were recorded.All data were analyzed by SPSS v.13.0.RESULTS: Metabolized uric acid by flora in 1 g feces of patients with CHD with normal levels of serum uric acid was significantly higher than in normal subjects(P<0.05),and metabolized uric acid of patients with CHD with elevated serum uric acid was comparable to that of normal subjects.No statistical difference was seen between CHD subgroups.Triglycerides of patients with CHD were significantly higher and high-density lipoprotein cholesterol was lower than in normal subjects(P<0.05,P<0.01).Total serum bilirubin of patients with CHD was significantly lower than normal subjects(P<0.05).CONCLUSIONS: Uricolysis of gut in subjects with CHD is significantly higher than in normal subjects.The gut may partially contribute to the abnormal metabolism of uric acid in the pathogenesis of CHD.Anti-oxidative ability of patients with CHD is lower than in normal subjects.