尿酸与慢性肾脏病相关性研究进展

Research progress on the correlation between uric acid and chronic kidney disease

尿酸(UA)是嘌呤代谢终产物,UA的生成与排泄改变将引起UA血清水平的变化。UA对肾脏的影响作用包括尿石症、肾损伤、慢性肾脏病(CKD)和高血压(HBP),是危害人类健康的主要公共疾病,上述疾病均使心脑血管疾病的风险增加。研究表明,UA与CKD和HBP的进展相关。除此之外,高尿酸血症(HUA)还通过损伤内皮细胞,激活RASS系统,诱导炎症产生,加重肾脏损伤。应用别嘌呤醇和非布司他治疗HUA,对管理HBP和延缓CKD进展具有重要意义。因此,UA不仅是肾脏疾病的标志物,而且还是潜在的治疗靶点。银杏叶提取物内含多种活性物质,例如银杏黄酮苷、银杏内酯和白果内酯等,这些活性物质在清除氧自由基、防止细胞衰老、对抗血小板活化、改善微循环方面发挥明显作用。银杏提取物能抑制NF-κB的激活,减少TNF-α、IL-6的生成,从而减弱单核/巨噬细胞和平滑肌细胞的过度反应,保护内皮细胞。本文从UA的代谢、UA水平和CKD的相关性及银杏叶提取物对血管的保护作用来进行综述。

Uric acid(UA)is the end product of purine metabolism.Changes in the production and excretion of UA will cause changes in the serum level of UA.The effects of UA on the kidneys are well known,including urolithiasis,kidney damage,chronic kidney disease(CKD)and hypertension(HBP),which are the major public diseases that endanger human health,all of which increase the risk of cardiovascular and cerebrovascular diseases.Research shows that UA is associated with the progression of CKD and HBP.In addition,hyperuricemia(HUA)also damages endothelial cells,activates RASS system,induces inflammation,and aggravates kidney damage.The application of allopurinol and febuxostat in the treatment of HUA is of great significance for the management of HBP and delaying the progress of CKD.Therefore,UA is not only a marker of kidney disease,but also a potential therapeutic target.Ginkgo biloba extract contains a variety of active substances,such as ginkgo flavone glycosides,ginkgolides and bilobalide,etc.These active substances play a significant role in scavenging oxygen free radicals,preventing cell aging,fighting platelet activation,and improving microcirculation.Ginkgo biloba extract can inhibit the activation of NF-κB,reduce the production of TNF-α and IL-6,thereby weaken the overreaction of monocytes/macrophages and smooth muscle cells,and protect endothelial cells.This article reviews the metabolism of UA,the correlation between the level of UA and kidney disease and the protective effect of Ginkgo biloba extract on blood vessels.