无症状高尿酸血症患者尿酸盐晶体致病性相关因素研究进展

Research progress on related factors of pathogenicity of urate crystals in patients with asymptomatic hyperuricemia

无症状高尿酸血症(AH)是以血清尿酸水平升高为特征的一种代谢性疾病。当血清尿酸水平超过饱和值后,尿酸盐晶体就会析出并沉积在关节滑膜、软骨及肾脏等组织诱发急性炎性反应。尿酸盐晶体是用于诊断痛风的金标准,但并非所有尿酸盐晶体沉积的AH患者最终都会发展为痛风。尿酸盐晶体沉积最终是否会引起痛风发作取决于尿酸盐晶体相关致病性基因、机体的免疫状态、软骨损伤以及滑液环境等多重因素的共同作用。明确尿酸盐晶体在AH发展为痛风过程中的致病性相关因素及其触发机制,能为AH患者中痛风高危人群的早期筛查、分层管理及个体化治疗提供依据。

Asymptomatic hyperuricemia(AH)is a common metabolic disease characterized by elevated serum concentrations of uric acid.When the serum uric acid exceeds the concentration threshold,urate crystals will crystallize and deposit in the synovium,cartilage and kidney to induce acute arthritis.Although urate crystals are the gold standard for the diagnosis of gout,not all patients with urate crystals deposition eventually develop gout.Whether urate crystal deposition will eventually cause the attack of gout depends on the joint action of multiple factors,such as urate crystal-related pathogenic genes,immune status,cartilage damage,synovial fluid environment and so on.To identify the pathogenic factors and trigger mechanism of urate crystals in the process of AH developing into gout,it can provide a basis for early screening,stratified management and individualized treatment of gout in patients with AH.