吡嗪酰胺诱导的高尿酸血症

Pyrazinamide-induced hyperuricemia

吡嗪酰胺诱导的高尿酸血症(pyrazinamide-induced hyperuricemia,PIHU)主要发生于抗结核治疗的强化期,在临床的发生率高,患者多无明显症状,因此防治PIHU容易被临床忽视。然而,随着结核病耐药形势愈趋严重,吡嗪酰胺在临床的应用更加广泛及长程(4~20个月),使得PIHU对治疗方案的制定及执行的影响愈显突出。我们针对上述问题,对PIHU的流行、发病机制、转归、防治等展开分析,特别针对特殊结核患者的PIHU进行了阐述,以引发更多关于PIHU的临床思考,为合理防治PIHU提供理论依据。

The pyrazinamide-induced hyperuricemia(PIHU)is prevalent during first two months(enhanced stage)of antituberculosis treatment,with a high incidence rate.Since PIHU is usually asymptomatic,the prevention and treatment of PIHU are easily overlooked in clinical practice.However,with the growing incidence of drug-resistant tuberculosis,pyrazinamide has been widely used in clinical treatment of drug-resistant tuberculosis,and the course of treatment is also prolonging(4-20 months),which makes PIHU display in a prominant position on the formation and implement of treatment scheme.Therefore,we analyzes the epidemiology,pathogenesis,outcome,prevention and treatment of PIHU,and particularly elucidate PIHU in some special patients with tuberculosis,with the expectation of arousing more clinical thought on PIHU,and provide further theory basis for prevention and treatment of PIHU.