Uric acid is the final product of purine metabolism in the human body, which is mainly discharged from the body through the kidney.The detection of uric acid is mainly through blood sampling test, which is a renal function item in the biochemical examination.High or low uric acid levels may indicate some health problems, such as simple hyperuricemiagout、nephritis、Hepatic necrosisandHepatolenticular degenerationAnd other diseases.
The clinical symptoms of uric acid may not be obvious, and many cases of hyperuricemia may last for several years without special symptoms.If the test result is more than 420 μ mol/L for men and more than 360 μ mol/L for women, it indicates hyperuricemia, which may indicate gout, nephritis and other diseases, and further examination should be carried out in time to find the underlying causes.The uric acid value is too low, lower than 150 μ mol/L for men and 89 μ mol/L for women, which may indicate the possibility of liver necrosis or hepatolenticular degeneration and other diseases.
Treatment of hyperuricemia mainly includes the use ofFebrista、Allopurinol、BenzbromaroneSuch drugs inhibit the production of uric acid or promote the excretion of uric acid, as well as treat primary diseases.To treat low uric acid, we need to find out and treat the underlying disease causes, such as avoiding irregular diet as far as possible, and paying attention to medication safety.
The normal value of uric acid is 150 ～ 416 μ mol/L for men and 89 ～ 357 μ mol/L for women by enzyme method.However, different laboratory testing methods may have different values, and different testing units will also affect the test results.
Abnormal indicators
Announce
edit
Uric acid test results exceeding the upper limit of normal value and lower than the lower limit of normal value indicate abnormality.It needs to exclude some physiological factors to have clinical significance.
Uric acid detected by enzyme method was more than 416 μ mol/L in men and more than 357 μ mol/L in women, indicating that uric acid was increased.Heightening usually indicates simplicityhyperuricemia、gout、nephritisAnd other diseases.
Uric acid detected by enzyme method is less than 150 μ mol/L for men and 89 μ mol/L for women, indicating that uric acid is reduced.Hint of decreased uric acidHepatic necrosis、Hepatolenticular degenerationEtc.
Result error
Announce
edit
The increase of uric acid in a single test is not necessarily caused by disease. Uric acid is greatly affected by diet, exercise and drugs. Therefore, it is meaningful to test uric acid on an empty stomach, in a quiet state and on a low purine diet for at least three days.
The impact of high purine diet on uric acid: uric acid in human body mainly comes from the metabolism of the body itself and the intake of daily diet. If high purine diet is carried out three days before the test, such as hot pot, seafood, chicken breast, animal viscera, etc., the exogenous intake of purine will greatly increase, exceeding the normal excretion load of the kidney, which will prompt the increase of uric acid.
Effect of drugs on uric acid: large doseGlucocorticoid、vitamin CIt can lead to increased excretion of kidney, increased excretion of uric acid, and decreased serum uric acid.
Effect of exercise on uric acid: after intense exercise, it will lead to a large amount of metabolic decomposition of ATP in skeletal muscle, leading to endogenouspurineThe production of uric acid will also increase.
Indicator interpretation
Announce
edit
The results were abnormal when uric acid exceeded the upper limit of normal value or was lower than the lower limit under strict 3-day low purine diet and quiet state.High uric acid usually indicates simple hyperuricemia, gout, nephritis and other diseases.Decreased uric acid is rarely seen clinically, suggesting liver necrosis, hepatolenticular degeneration, etc.Uric acid examination can also be combined with urea nitrogen, creatinine, kidney color ultrasound and other examinations. When urea nitrogen, creatinine are significantly increased and the size of the kidney changes, it can help diagnose nephritis.
Index identification
Announce
edit
Uric acid meansSerum uric acid, easily confused with uric acid.Uric acid is mainly collected for 24 hours and mixed, and the content of uric acid is detected, which is also used to reflect the metabolism and excretion of uric acid.
The increase of uric acid indicates the increase of uric acid accumulation in the body, which can be understood as excessive intake and metabolism, too little excretion, and may indicate gout, nephritis and other diseases.
The increase of uric acid indicates the increase of uric acid excretion, which may be caused by excessive intake of metabolic decomposition, and renal reabsorption disorders, such as myeloma, leukemia, hemolytic anemia, hyperthyroidism, etc. It is worth noting that the increase of uric acid caused by renal reabsorption dysfunction, and the decrease of blood uric acid, such as hepatolenticular degeneration, etc.The decrease of uric acid is usually accompanied by the increase of blood uric acid, which is mostly seen in renal insufficiency and the prophase of gout attack.
High indicators
Announce
edit
The clinical reference value of uric acid should be more than 420 μ mol/L for men and 360 μ mol/L for women, indicating hyperuricemia, which can also be the symptom of some diseases, such as gout, nephritis and other diseases, and the cause should be found in time.High uric acid may be a physiological phenomenon, such as eating a lot of high purine food 3 days before the detection of uric acid.
Reasons for high
The increase of uric acid may be caused by physiological factors or disease factors.
Physiological factors
If a large amount of high purine diet is taken before the detection of uric acid, the amount of exogenous purine will increase greatly, which will seriously affect the directivity of uric acid results to diseases. Common high purine foods include hot pot, seafood, chicken breast, animal viscera, etc.Severe exercise will lead to the decomposition of ATP in a large number of muscles, the increase of purine production, and the increase of uric acid.
Pathological factors
Common diseases include simple hyperuricemiagout, nephritis and other diseases.
Simple hyperuricemia: the patient only has increased uric acid, without special clinical symptoms, and most of them are caused by purine metabolism disorders.
Gout: it is the most common and main cause of uric acid increase. Although the pathogenesis has not been clearly studied, it is related to purine metabolism disorder and abnormal uric acid excretion, which will lead to increased uric acid production and decreased excretion, leading to the accumulation of uric acid in the body.
Nephritis: Nephritis patients are usually accompanied by a decline in renal function. Abnormal renal filtration and excretion function will reduce the amount and speed of uric acid excretion, cause uric acid accumulation, and lead to increased uric acid.
Indication for medical treatment
The increase of uric acid may be caused by physiological factors or diseases. Patients need to learn to identify themselves.
By enzyme-linked immunosorbent assay, the normal uric acid is between 150~416 μ mol/L for men and 89~357 μ mol/L for women. If the uric acid is slightly increased, it does not exceed one fifth of the upper limit of the normal value, the patient can consider whether there is a high purine diet and whether there is strenuous exercise in the past three days. The increase of uric acid is greatly affected by food and drink and exercise. The patients with slight increase need not panic too much,You can adjust your diet and rest habits and retest. If the second test is within the normal range, no special treatment is required. If it is still high after reexamination, you need to improve other tests to exclude diseases.
If uric acid is still high after strict low purine diet, enough attention should be paid.Although most people do not have special symptoms when they first find that uric acid is increased, and this high uric acid state may last for more than ten years, patients still need to be further screened.
Especially when uric acid exceeds 600 μ mol/L, it is necessary to take medicine to reduce uric acid.There are many diseases that can lead to hyperuricemia, but the most relevant ones are gout and various nephritis. Professional doctors will guide patients to do color ultrasound, urine protein and other tests for differential diagnosis.
inspect
High uric acid requires vigilance against gout and nephritis, timely medical treatment and perfect examination.May involve urea nitrogen, creatinine, kidney color ultrasound and other examinations.
treatment
After finding that uric acid is increased, doctors need to treat diseases in addition to reducing uric acid.
Reducing uric acid: useFebrista、Allopurinol、BenzbromaroneSuch drugs inhibit uric acid production or promote uric acid excretion.
Treatment for causes: In case of gout, besides uric acid, non steroidal anti-inflammatory drugs, glucocorticoids and other drugs are also needed to alleviate the symptoms of patients. If there are too many gout stones, some patients may also need surgery to remove the stones.The increase of uric acid caused by kidney diseases is mainly to treat primary diseases. For example, patients with chronic nephritis need to take kidney function protection drugs or even hemodialysis, and systemic lupus erythematosus nephritis needs to use immunosuppressants.
Dietary guidance
Diet plays a very important role in the treatment of high uric acid.
Avoid high purine diet: high purine diet should be avoided, such as hot pot, barbecue, seafood, animal viscera, etc.
Abstinence: Due to the complex role of alcohol in the metabolism and production of uric acid, abstinence is necessary to maintain the stability of uric acid in human body.
Drink more water: In order to promote the excretion of uric acid, patients need to drink a lot of water. It is recommended that the daily amount of water should be more than 2000ml.
Daily attention
Vigorous exercise is prohibited, but moderate and regular exercise is beneficial to the recovery of disease, such as swimming, jogging, tai chi, etc.
Live regularly, and pay attention to increase or decrease clothing appropriately with the weather to avoid catching cold.
Curative
Simple hyperuricemia can be reduced to normal after diet and drug treatment when the patient does not have relevant clinical symptoms.When the uric acid value of men recovers to 150 ～ 416 μ mol/L, and that of women recovers to 89 ～ 357 μ mol/L, it is considered to be cured.As far as simple hyperuricemia is concerned, it can be cured.
If symptoms have appeared, such as gout, nephritis and other diseases, there is no cure.This is mainly because the purine metabolism in the body can not be restored to normal levels.These diseases can not be cured, and can only be controlled through treatment.
Indicators are low
Announce
edit
Uric acid value is lower than 150 μ mol/L in men and 89 μ mol/L in women, indicating a low level.It means that the function of the liver to generate uric acid is reduced or the kidney is unable to reabsorb uric acid, which will indicate liver necrosis, hepatolenticular degeneration and other diseases.
Reasons for low
The increase and decrease of uric acid may be caused by physiological factors, pharmaceutical factors and disease factors, which will be described in detail below.
Physiological factors
The reduction of exogenous purine intake after a long time of eating will also lead to low uric acid.
Pharmaceutical factors
High dose of glucocorticoid and vitamin C can lead to increased excretion of kidney, increased excretion of uric acid, and decreased serum uric acid.
Disease factors
Liver necrosis: after liver necrosis, liver function will be affected. Since liver is the main place for purine metabolism to generate uric acid, when liver necrosis occurs, uric acid production will be reduced accordingly.
Hepatolenticular degeneration: mainly due to liver failurehemolysis、encephalopathyIs the main performance.The principle is the same as above.
Indication for medical treatment
The high uric acid may be caused by physiological factors, drugs, or diseases. It is difficult for general patients to identify themselves and need to seek medical advice.
Physiological factors: detection of decreased uric acid.In case of diet reduction, taking glucocorticoid and vitamin C three days before the examination, it is necessary to stop taking the medicine for at least three days for reexamination. If the reexamination results are normal, no special treatment is required.
Disease factors: uric acid is lower than 80 μ mol/L, excluding the above physiological factors.There may be insufficient uric acid synthesis or purine metabolism disorder.It is necessary to be alert to liver diseases such as liver necrosis and hepatolenticular degeneration.Patients may suffer from fatigue, jaundice, anorexia, and even coma in severe cases. They need to seek medical attention in time.
inspect
Low uric acid requires vigilance against liver necrosis, hepatolenticular degeneration and further examination.
Hepatic necrosis: Transaminase, bilirubin, abdominal color ultrasound, etc. all contribute to the diagnosis of liver necrosis. Transaminase and bilirubin are significantly increased. Abdominal color ultrasound indicates liver structural disorder or liver cirrhosis.
Hepatolenticular degeneration: It is a genetic disease, and gene testing is the most important method for diagnosis.Transaminase, bilirubin, abdominal color ultrasound and blood routine examination are helpful to judge the degree of liver injury and hemolysis.
treatment
The treatment of low uric acid is very important for the treatment of primary diseases.
Liver necrosis: to find the cause of liver necrosis, the use of this drug should be stopped for drug injury, and effective liver protection treatment should be carried out. The commonly used drugs are sunny and sweet.Viral infection requires active antiviral treatment, and ganciclovir is commonly used.
Hepatolenticular degeneration: It is incurable and can only be treated symptomatically. Dimercaptopropane sulfonic acid and zinc preparations can promote copper excretion and help alleviate symptoms.
Dietary guidance
Try to eat a balanced diet to avoid eating irregularly and not eating for a long time.
Daily attention
Pay attention to medication safety: glucocorticoid, vitamin C and other drugs will affect the metabolism of uric acid, causing a low level.
Curative
Through active treatment and daily life management, some patients with low uric acid can be cured.
The uric acid level is low due to medication and low food intake. When the drug is stopped and the normal food intake is restored, the uric acid level can quickly return to the normal level.
Acute liver injury can be treated by antiviral, liver protection and other drugs. The liver has recovered its function of synthesizing uric acid, and the uric acid has returned to normal level after recheck. The liver function has recovered, and the low uric acid has also been cured.After the patient is cured, he needs to keep a good rest, eat meat and eggs to supplement nutrition, and go to the hospital once every two weeks to check the liver function and uric acid.
Hepatolenticular degeneration is an inherited disease, which cannot be cured.Only drugs that promote copper excretion and absorption can alleviate the disease.
In short, the reason for low uric acid needs to be clarified.After effective treatment of acute liver injury, low uric acid can be cured.However, hepatolenticular degeneration, a hereditary disease, can only be alleviated.
Numbering system
Announce
edit
MDL No.: MFCD00005712
RTECS No.: YU7050080
BRN No.: 156158
PubChem No.: 24900634
toxicology data
Announce
edit
Reproduction: TDLo: 5040 mg/kgSex/duration: male 4 week (s) pre dating;
Mutagenicity: Human lymphocyte Mutation test systems - not otherwise specified Test system: 10 mmol/L;
Ecological data
Announce
edit
Water hazard level 1 (German regulation) (self-assessment through the list) The substance is slightly harmful to water.Do not allow undiluted or large quantities of products to come into contact with groundwater, waterways or sewage systems.Do not discharge materials into the surrounding environment without government permission.
Calculate chemical data
Announce
edit
1. Drainage parameter calculation reference value (XlogP): - 1.9
11. Determine the number of atomic structure centers: 0
12. Number of uncertain atomic structure centers: 0
13. Determine the number of chemical bond structural centers: 0
14. Number of indeterminate chemical bond structure centers: 0
15. Number of covalent bond units: 1
Properties and stability
Announce
edit
When heated to above 400 ℃, hydrocyanic acid is decomposed without melting, so it cannot be subjected to strong heat.
Storage method
Announce
edit
Sealed in brown wide mouth glass bottles.Store in a cool and dry place.
synthetic method
Announce
edit
one
Take dried chicken manure and suspend it in 24 times amount of water, add proper amount of calcium hydroxide, and then stand still.After the precipitation is complete, the supernatant is separated, and water is added in the precipitationnitric acidAdjust the pH value to 3, and let it stand until the precipitation is complete.
two
Separate the supernatant, suspend the sediment in water, adjust the pH value to 12~12.5 with calcium hydroxide, adjust the pH value of the filtered filtrate to 3 with nitric acid, and filter and dry the precipitate to form crude uric acid.
purpose
Announce
edit
1. Reagent that can be used to determine uricase and tungstate.Uric acid and its derivatives have no side effects on the skin, and have various conditioning functions when used in cosmetics.It has significant moisturizing function, can treat skin dysfunction, has antioxidant property, can delay skin aging and prevent skin cancer.
2. It can treat excessive dandruff. Adding 0.001% into hair care products can effectively inhibit dandruff.
Formation process
Announce
edit
uric acid
Nucleic acid is a kind ofPolymer compoundNucleic acid is composed of countless nucleotides.every lastnucleotideThey are composed of three parts, one phosphoric acid molecule and one pentose（Pentose）And aBase（purineorpyrimidine）。Genetic material DNA in biological nucleus（Deoxyribonucleic acid）And RNA in cytoplasm（Ribonucleic acid）It is composed of hundreds of thousands, millions or even tens of millions of nucleotides.On the contrary, purine is one of the products of nucleic acid oxidation and decomposition, so purine is a component of cells.
Old cells in the body, as well as food, especially food rich in purine (such as animal viscera, seafood, etc.)the new supersedes the oldIn the process, purine (thisendogenous80% of the total purines).After purine is produced in the body, it will be oxidized again in the liver to (2,6,8-trioxypurine), also known as uric acid.2/3 of uric acid is excreted through the kidney with urine, and 1/3 is excreted through feces and sweat.It can be seen that purine is the metabolic product of the oxidative decomposition of nucleic acid, while uric acid is the final product of purine metabolism, in which the purine ring has not been untied.
Common foods containing more than 600mg purine per 100g of food
