慢性高尿酸血症肾病36例临床分析

Clinical analysis of chronic hyperuricemia: A report of 36 cases

对１９９２～１９９７年住院的３６例原发性高尿酸血症肾病总结分析。其占同期原发性痛风的７５％，伴有关节损害者占８３％。据ＢＵＮ、Ｓｃｒ值，将患者分为非肾衰组与肾衰组。肾衰组合并高血压者显著高于非肾衰组；两组尿渗透压／血渗透压比值几乎均＜１．５；肾衰组血尿酸／血肌酐＞２．５仅４７％；尿尿酸排泄量肾衰组较非肾衰组显著减少。提示尿酸性肾病多数伴有关节炎，且肾功能损害进展缓慢，早期以肾小管功能损害为主。

Thirty six hospitalized patients (from 1992 to 1997) with primary hyperuricemia were analysed, of which 75% were primary gout, 83% complicated with injury of joint. Based on blood uric nitrogen and serum creatinine parameters, the patients were divided into non-renal failure group and renal failure one. The ratio of urine osmotic pressure to blood osmotic pressure was almost below 1.5; only 47% of the ratio of blood uric acid to blood creatinine in renal failure group was higher than 2.5. The uric acid capacity in the renal failure group was less than the non-renal failure group. It indicated that most uric acid renal failure complicated with arthritis, and the renal function were slowly deteriorated, and the renal tubular was mainly injured in the early stage. In addition, the uric acid renal disease can not be simply judged by the ratio of blood uric acid to blood creatinine.