URAT1基因在尿酸结石患者肾脏的表达及其临床意义

Expression and clinical significance of URAT1 in renal tissue of patients with uric acid nephrolithiasis

目的探讨尿酸结石患者尿酸代谢特征以及肾脏URAT1表达改变的意义。方法回顾性分析2012年1月至2013年10月我院收治的24例结石患者的临床资料,按结石成分分为尿酸结石患者9例(A组)、非尿酸性结石患者15例(B组),另选取7例因其他疾病操作而取材做m RNA测定的患者为C组,10例健康体检者为D组(仅用作收集其血尿酸检验结果以及24 h尿液标本)。采集各组参与者一般临床资料以及血液、24 h尿液的尿酸代谢相关指标结果,并应用Real-time PCR技术检测其肾脏URAT1表达情况,所得数据进行组间统计分析比较。结果 A组患者血尿酸水平、体重指数、年龄显著高于B组及C组(P<0.05),而尿PH值显著降低。24 h尿量及尿酸定量分析各组间无明显差异(P>0.05)。Real-time PCR实验结果提示尿酸结石患者肾脏URAT1表达较其他组显著增高(P<0.05)。结论尿酸结石患者与高尿酸血症密切相关,而肾脏尿酸排泄无明显改变,URAT1在肾脏高表达可能是这一临床特征的重要分子机制。

Objective To investigate the metabolic profile of uric acid and the significance of the altered renal expression of urate transporter 1（ URAT1） in patients with uric acid nephrolithiasis. Methods The data of 24 patients in our hospital from January 2012 to October2013 were analyzed retrospectively. Participants in the research were divided into three groups： patients with uric acid nephrolithiasis,other patients with nephrolithiasis and normal participants. The basic clinical data and the related data of uric acid metabolition of participants were collected,URAT1 gene expression in renal tissures of three groups was detected by Real-time PCR technique. All data were statistically analyzed and compared between these groups. Results Uric acid levels in plasma,body mass index and age were significantly higher in patients with uric acid nephrolithiasis than other two groups（ P〈0. 05）,but urine PH value was significantly reduced in patients with uric acid nephrolithiasis. Urine and uric acid output of 24 hours urine were no significant difference among the three groups（ P〈0. 05）. The result of Realtime PCR suggested that the URAT1 renal expression was significantly higher in patients with uric acid nephrolithiasis than other two groups（ P〉0. 05）. Conculusion Patients with uric acid nephrolithiasis are closely related with hyperuricemia,but unrelated with renal over-excretion of uric acid. The upregulated URAT1 expression in the kidney may be an important molecular mechanism of the clinical features.