无症状性高尿酸血症的诊断与治疗
Diagnosis and treatment of asymptomatic hyperuricemia
尿酸是人体嘌呤代谢的产物.在正常情况下,人体每天尿酸的产生和排泄基本上保持动态平衡,凡是影响血尿酸生成和(或)排泄的因素均可以导致血尿酸水平增加.国际上将高尿酸血症(HUA)的诊断标准定义为男性血尿酸水平>420 μmol/L(7 mg/dl),女性>357 μmol/L(6 mg/dl),无痛风发作的HUA称为无症状HUA.约有5%~12%的HUA患者最终会发展成为痛风.无症状HUA的治疗包括改善生活方式、积极控制与血尿酸升高相关的代谢性危险因素、避免应用使血尿酸升高的药物、碱化尿液,降低血尿酸的药物包括增加尿酸排泄的药物、抑制尿酸合成药物、辅助降尿酸药、中药.降尿酸治疗的目标是促进晶体溶解和防止晶体形成,血尿酸应<357 μmol/L(6 mg/dl).
更多Uric acid is a product of human purine metabolism. The production and excretion of uric acid per day in the body maintains dynamic balance basically under normal circumstances, and any factor that affects formation and (or) excretion of uric acid can lead to increased serum uric acid level. The international diagnostic criteria of hyperuricemia (HUA) is defined as serum uric acid > 420 μmol/L ( 7 mg/dl) in male, >357 μmol/L (6 mg/dl) in female,and no gout attack is called asymptomatic HUA. There are about 5%-12% of patients with HUA will eventually develop into gout. The treatment of asymptomatic HUA includes improving lifestyle, controlling serum uric acid-related metabolic risk factors aggressively, avoiding application of drugs which increased serum uric acid, and alkaline urine. The drugs which can reduce the blood uric acid include drugs that increased uric acid excretion, inhibited uric acid synthetic, auxiliary drugs,and traditional Chinese medicine. The goal of reducing uric acid is to promote crystal dissolution and prevent crystal formation,and serum uric acid should be <357 μmol/L (6 mg/dl).
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