不同嘌呤含量饮食对老年高尿酸血症患者血尿酸水平和尿尿酸排泄的影响

Influence of different contents of purines in diets on serum uric acid and its excretion in hyperuricemic elderly men

  • 摘要: 目的: 探讨不同嘌呤含量饮食对老年男性原发性高尿酸血症血尿酸及肾脏尿酸排出的影响。方法: 老年男性原发性高尿酸血症患者10例,年龄60~84(74.4±7.84)岁。给予3 d低嘌呤饮食和3 d高嘌呤饮食,低嘌呤饮食中嘌呤含量<250 mg/d,高嘌呤饮食中嘌呤含量>800 mg/d。分别于低嘌呤饮食前、后及高嘌呤饮食后3次抽血监测相关生化指标,并分别留取3次24 h尿监测尿酸(Uur)、尿肌酐(Ucr),计算肾脏排尿酸能力的指标。结果: 低嘌呤饮食后血尿酸水平明显下降,而高嘌呤饮食后血尿酸水平明显升高。24 h尿尿酸(Uur)、尿尿酸/尿肌酐比值(Uur/Ucr)、尿酸排泄分数(Feur)、尿酸肾小球滤过(EurGF)在低嘌呤饮食后和高嘌呤饮食后都明显增加。低嘌呤饮食后尿Uur、Feur明显大于高嘌呤饮食后。结论: 限制饮食中嘌呤在250 mg/d以下可使血尿酸水平下降,同时还使尿酸的排出量和尿酸排泄分数增加。高尿酸血症患者限制饮食中的嘌呤、蛋白质和脂肪的摄入量有利于控制血尿酸水平和保护肾功能。

     

    Abstract: Objective: To investigate the influence of different contents of purines in diets on serum uric acid and its excretion in hyperuricemic elderly men.Methods: Ten hyperlipidemic elderly men mean age(74.4±7.84) years old consumed high-purine(<800 mg/d) and low-purine diets(<250 mg/d) for three days.At onset and after purine load,the samples of fasting blood and 24h urine samples were collected for determination of serum biochemical variables,and 24h uric acid urinary excretion,24h urinary creatinine,Urinary uric acid excretion was calculated.Results: The levels of serum uric acid were decreased and increased respectively after low and high purine diets.The patients with hyperuricemia showed 24h uric acid urinary excretion,urinary uric acid to creatinine ratio,fractional excretion of uric acid and excretion of uric acid per volume of glomerular filtration were increased significantly both at low and high purine diets.The uric acid clearance and fractional excretion of uric acid were significantly higher in low purine diets than in high purine diets.Conclusion: Low purine diets with purine <250 mg/d significantly decrease serum uric acid level of patients with hyperuricemia and elevate renal excretion of uric acid.The serum uric acid level is significantly increased by high purine content diets.The dietary restriction of purines,protein and fat intake is effective to control serum uric acid level and protect renal function.

     

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