Yuav ua li cas lub raum puas los ntawm High Uric Acid Kauj Ruam?

Hyperuricemia (HUA) ua rau lub raum puas thiab muab faib ua peb hom:

1. Mob uric acid nephropathy yog tshwm sim los ntawm kev tso tawm ntawm ntau cov uric acid crystals nyob rau hauv lub raum interstitium thiab lub raum tubules. Lub raum tubular lumen tau sau thiab thaiv los ntawm uric acid, ua rau oliguric mob raum tsis ua haujlwm. Nws tshwm sim nyob rau theem ob gouty nephropathy, xws li lytic nephropathy. qog syndrome.

2. Cov kab mob uric acid nephropathy yog tshwm sim los ntawm kev tso tawm ntawm urate crystals nyob rau hauv lub raum medulla. Nws tshwm sim hauv thawj gouty nephropathy, thiab Lao Li belongs rau hom no.

3. Uric acid raum pob zeb tuaj yeem pom nyob rau hauv thawj thiab theem nrab gouty nephropathy.

Nyem rau Cistanche rau mob raum

Tam sim no ntseeg tias cov txheej txheem uas HUA ua rau lub raum puas yog raws li hauv qab no [1,2]:

1 Renin-angiotensin system (RAS)

thiab ua kom cov cyclooxygenase 2 (COX-2) system

High uric acid activates RAS, ua rau lub cev kub siab, siab intraglomerular siab, hyperperfusion, thiab raum fibrosis. Angiotensin II (AngII) tuaj yeem tswj cov kev qhia ntawm COX-2 thiab prostaglandin ntau lawm los ntawm mitogen-activated protein kinase (MAPK) teeb liab txoj kev, yog li ua rau vascular du leeg cell proliferation, hypertrophy thiab infiltration ntawm inflammatory hlwb nyob rau hauv lub raj. phab ntsa.

2 Endothelial cell tsis ua haujlwm

Uric acid inhibits kev tsim cov nitric oxide (NO) hauv cov hlwb endothelial thiab txo nws cov haujlwm los ntawm cov txheej txheem nyuaj. Raws li cov antioxidant ntau tshaj plaws hauv lub cev, nws ncaj qha noj ntau ntawm NO thiab tsim 6-aminouracil, ua rau endothelial cell dysfunction. , ua rau cov nyhuv vasodilation tsis muaj zog thiab ua rau qeeb zuj zus ntawm cov hlwb endothelial, yog li ua rau kub siab thiab vascular txhab.

3. Lub luag haujlwm ntawm inflammatory yam

Raws li qhov ua rau muaj kev mob tshwm sim, uric acid tuaj yeem txhawb kev sib txuas ntawm platelet-derived growth factor (PDGF) thiab txhawb kev tsim cov tshuaj monocyte chemotactic factor (MCP-1), interleukin-1 (lL{{4}). }}) thiab qog nqaij hlav necrosis los ntawm monocytes. (TNF-ɑ) thiab lwm yam inflammatory yam, thiab cov inflammatory yam uas tau hais los saum no yog ncaj qha los yog tsis ncaj qha cuam tshuam rau lub raum puas.

4 rog rog

Qhov tshwm sim ntawm gout nyob rau hauv cov neeg mob rog rog yog 2 npaug ntau dua li ntawm cov pejxeem. Cov adipocytokines secreted los ntawm cov roj hauv tib neeg lub cev tuaj yeem ua rau lub paj hlwb ua rau lub cev tsis muaj zog, ua rau cov zis sodium tsis muaj zog los ntawm kev siv lub cev ntawm RAS thiab ob lub raum, thiab txhim kho qhov tseem ceeb ntawm sodium hauv lub raum tubules. Kev nqus dej ua rau sodium thiab dej tuav ua rau kub siab, ua rau glomerular hyperfiltration xeev. Tsis tas li ntawd, Leptin, TNF-ɑ thiab IL-6 tso tawm los ntawm cov ntaub so ntswg adipose ncaj qha txhawb cov kev mob tshwm sim thiab ua rau lub raum puas.

5 Lipid metabolism tsis zoo

Lipid deposition nyob rau hauv epithelial hlwb nkoos zus tau tej cov cytokines, ncaj qha stimulating epithelial hlwb los tsim extracellular matrix, thiab koom nyob rau hauv kev puas tsuaj ntawm lub raum tubular epithelium los ntawm oxidation, prompting epithelial hlwb los tsim ntau yam cytokines ntsig txog o, fibrosis, thiab lwm yam. ., ncaj qha los yog Indirectly koom nrog nyob rau hauv cov mob loj zuj zus ntawm lub raum tubules thiab interstitium.

Tsis tas li ntawd, cov kev tshawb fawb kuj pom tau hais tias ib puag ncig cov hlau lead raug, kev hloov hauv urate transporter kev ua, thiab caj ces tseem muaj feem cuam tshuam rau qhov tshwm sim ntawm gouty nephropathy.

Tsis tsuas yog HUA nws tus kheej tuaj yeem ua rau lub raum puas tsuaj los ntawm cov txheej txheem hais saum toj no, tab sis nws kuj yog ib qho kev ua haujlwm ywj pheej rau IgA nephropathy, mob ntshav qab zib nephropathy, mob raum mob, mob raum raug mob, thiab lwm yam, thiab yuav ua kom cov txheej txheem ntawm lub raum puas. kab mob saum toj no [3].

Kev kho mob gouty nephropathy

1 Kev ua neej nyob

Poob qhov hnyav, txwv tsis pub muaj purine-nplua nuj nqaij thiab nqaij nruab deg, txwv cov khoom noj uas muaj fructose, tsis txhob noj cov khoom noj muaj roj tsawg lossis tsis muaj rog, thiab txwv tsis pub haus cawv los tswj HUA. Cov kev tshawb fawb soj ntsuam tau pom tias kev hloov hauv kev ua neej ib leeg tuaj yeem txo SUA qib los ntawm 10% mus rau 18% [3,4].

2. Tshuaj

Cov tshuaj uas inhibit uric acid synthesis

Allopurinol

Nws tseem yog thawj kab tshuaj rau kev kho mob hyperuricemia, muaj zog uric acid-txo cov nyhuv, kev ua siab ntev, thiab kev ua haujlwm siab. Nws cov metabolite oxypurine yog qhov tseem ceeb ntawm kev txo qis uric acid thiab feem ntau yog tawm los ntawm ob lub raum. Thaum lub raum ua haujlwm poob qis, cov koob tshuaj yuav tsum raug txo kom tsim nyog kom tsis txhob muaj kev txuam nrog hauv lub cev ua rau muaj kev phiv loj heev. Nyob rau hauv xyoo tas los no, cov xwm txheej ntawm cov tshuaj tua kab mob tuag tau raug tshaj tawm tsis tu ncua nrog allopurinol. Cov kev tshawb fawb tau pom tias qhov tshwm sim ntawm qhov tshwm sim tsis zoo no cuam tshuam rau cov neeg uas zoo rau HLA-B * 5801 allele. Nws raug pom zoo tias cov neeg mob tau kuaj cov caj ces ua ntej noj cov tshuaj, uas txwv tsis pub nws daim ntawv thov.

febuxostat

Kuj hu ua febuxostat, nws inhibits kev ua ntawm xanthine oxidase, tiv thaiv thiab txo cov synthesis ntawm uric acid los ntawm hypoxanthine thiab xanthine, yog li txo cov ntshav uric acid. Tsis zoo li allopurinol, febuxostat feem ntau yog metabolized nyob rau hauv daim siab, thiab ib tug me me npaum li cas los ntawm lub raum. Rau cov neeg mob uas mob me mus rau nruab nrab lub raum tsis txaus, tsis tas yuav kho qhov koob tshuaj. Nws yog qhov tsim nyog rau cov neeg uas muaj kev fab tshuaj lossis tsis haum rau allopurinol lossis nws txoj kev kho mob tsis zoo. Feem ntau pom zoo rau kev kho mob ntev hyperuricemia hauv cov neeg mob uas muaj keeb kwm ntawm gout.

Cov tshuaj uas txhawb nqa uric acid excretion

Hom tshuaj no ua rau kom cov kua qaub uric nce ntxiv los ntawm inhibiting reabsorption ntawm urate ions los ntawm lub raum raum tubules, yog li txo qhov concentration ntawm urate hauv cov ntshav. Nws tuaj yeem txo lossis tiv thaiv kev tsim ntawm urate crystals, txo kev puas tsuaj ntawm kev sib koom tes, thiab tseem tuaj yeem txhawb kev sib cais ntawm cov khoom siv urate.

Representative drugs are benzbromarone and probenecid. These drugs increase the risk of urinary tract stones. When using these drugs, you should pay attention to drinking more water and using drugs that alkalize urine. Before using such drugs, the urinary uric acid excretion should be measured. If the patient's 24-hour urinary uric acid excretion is >3.54 mmol lossis muaj pob zeb hauv cov zis, cov tshuaj no raug txwv. Cov neeg mob uas muaj kab mob rwj lossis lub raum tsis txaus yuav tsum siv ceev faj. Tsis tas li ntawd, benzbromarone yog hepatotoxic, yog li cov neeg mob lub siab ua haujlwm yuav tsum tau saib xyuas thaum siv nws.

Uricase tshuaj

Uricase tuaj yeem oxidatively degrade uric acid rau hauv allantoin, uas tuaj yeem txo cov ntshav uric acid thiab ua tiav lub hom phiaj ntawm kev kho mob hyperuricemia. Tam sim no, recombinant uricase yog maj mam txhim kho nyob rau hauv cov nqe lus ntawm antigenicity thiab ib nrab-lub neej, thiab nws yuav dhau los ua ib txoj kev tshiab los txo uric acid. Lub ntsiab biosynthetic urate oxidases yog:

Recombinant Aspergillus flavus urate oxidase (rasburicase)

Rau kev kho mob thiab tiv thaiv tus mob hyperuricemia hauv cov neeg mob uas muaj hematological malignancies uas muaj kev pheej hmoo siab rau cov qog lysis syndrome, tshwj xeeb tshaj yog rau cov neeg mob uas muaj tshuaj kho mob hyperuricemia. Cov ntshav uric acid theem ntawm cov neeg mob siv cov tshuaj no poob sai heev thiab tseem nyob rau theem qis nyob rau hauv lub sij hawm induction chemotherapy.

Pegylated recombinant urate oxidase (PEG-uricase)

Siv intravenously, nws tuaj yeem sai thiab muaj zog txo cov ntshav uric acid. Nws yog tsuas yog siv rau cov neeg mob hnyav HUA, refractory gout, tshwj xeeb tshaj yog qog lysis syndrome. Cov tshuaj sawv cev yog pegloticase, uas yog pegylated uric acid tshwj xeeb enzyme. Uricase yog covalently khi rau polyethylene glycol los ntawm monomethyl ether daim ntawv cog lus thiab feem ntau yog tawm los ntawm ob lub raum.

lwm yam

Tsis tas li ntawd, cov tshuaj xws li colchicine, losartan, fenofibrate, thiab cilnidi kuj muaj uric acid-txo cov teebmeem.

Kev nce hauv cov ntshav creatinine kuj ua rau Lao Li paub txog qhov tseem ceeb ntawm kev tswj hwm kev noj haus thiab koom tes nrog cov kws kho mob cov tshuaj kho mob hauv kev kho mob gouty nephropathy. Txij thaum ntawd los, nws muaj tsawg dua kev tawm tsam ntawm gout, thiab nws lub raum kev ua haujlwm tau zoo li qub thiab ruaj khov nyob ib ncig ntawm 160 μmol / L.

Cistanche kho mob raum li cas?

Cistancheyog ib hom tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho ntau yam mob, suav nrograumkab mob. Nws yog muab los ntawm qhuav stems ntawmCistanchedeserticola, ib tsob nroj nyob rau hauv cov suab puam ntawm Tuam Tshoj thiab Mongolia. Lub ntsiab active Cheebtsam ntawm cistanche yogphenylethanoidglycosides, echinacoside cov tshuaj, thiabacteoside, uas tau pom tias muaj txiaj ntsig zoo rau lub raum kev noj qab haus huv.

Kab mob raum, tseem hu ua kab mob raum, hais txog ib yam mob uas lub raum ua haujlwm tsis zoo. Qhov no tuaj yeem ua rau muaj cov khoom pov tseg thiab cov co toxins hauv lub cev, ua rau muaj ntau yam tsos mob thiab teeb meem. Cistanche tuaj yeem pab kho mob raum ase los ntawm ntau lub tshuab.

Ua ntej, cistanche tau pom tias muaj cov nyhuv diuretic, txhais tau tias nws tuaj yeem ua rau cov zis ntau ntxiv thiab pab tshem tawm cov khoom pov tseg ntawm lub cev. Qhov no tuaj yeem pab txo lub nra ntawm lub raum thiab tiv thaiv kev tsim cov co toxins. Los ntawm kev txhawb nqa diuresis, cistanche kuj tseem tuaj yeem pab txo qis ntshav siab, ib qho teeb meem ntawm cov kab mob raum.

Ntxiv mus, cistanche tau pom tias muaj cov teebmeem antioxidant. Kev ntxhov siab oxidative, tshwm sim los ntawm qhov tsis sib xws ntawm kev tsim cov dawb radicals thiab lub cev tiv thaiv antioxidant, ua lub luag haujlwm tseem ceeb hauv kev mob raum. ies pab neutralize dawb radicals thiab txo Oxidative kev nyuaj siab, yog li tiv thaiv lub raum los ntawm kev puas tsuaj. Cov phenylethanoid glycosides pom hauv cistanche tau tshwj xeeb hauv kev tshem tawm cov dawb radicals thiab inhibiting lipid peroxidation.

Tsis tas li ntawd, cistanche tau pom tias muaj cov nyhuv anti-inflammatory. Kev mob yog lwm yam tseem ceeb hauv kev loj hlob thiab kev loj hlob ntawm cov kab mob raum. Cistanche's anti-inflammatory zog pab txo cov zus tau tej cov pro-inflammatory cytokines thiab inhibit qhov ua kom o yuav tsum tau txoj kev, yog li alleviating o nyob rau hauv lub raum.

Tsis tas li ntawd, cistanche tau pom tias muaj cov teebmeem immunomodulatory. Hauv kab mob raum, lub cev tiv thaiv kab mob tuaj yeem ua rau tsis zoo, ua rau muaj kev mob ntau dhau thiab cov ntaub so ntswg puas. Cistanche pab tswj lub cev tiv thaiv kab mob los ntawm kev hloov kho kev tsim khoom thiab kev ua haujlwm ntawm lub cev tiv thaiv kab mob, xws li T hlwb thiab macrophages. Txoj cai tiv thaiv kab mob no pab txo qhov mob thiab tiv thaiv kev puas tsuaj ntxiv rau lub raum.

Ntxiv mus, cistanche tau pom los txhim kho lub raum kev ua haujlwm los ntawm kev txhawb nqa kev tsim kho ntawm lub raum hlab nrog cov hlwb. Lub raum tubular epithelial hlwb ua lub luag haujlwm tseem ceeb hauv kev pom thiab rov nqus cov khoom pov tseg thiab electrolytes. Hauv kab mob raum, cov hlwb no tuaj yeem raug puas tsuaj, ua rau lub raum ua haujlwm puas. Cistanche lub peev xwm los txhawb kev tsim kho ntawm cov hlwb no pab kho lub raum kom zoo thiab txhim kho lub raum tag nrho.

Ntxiv nrog rau cov kev cuam tshuam ncaj qha rau lub raum, cistanche tau pom tias muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev hauv lub cev. Txoj hauv kev zoo rau kev noj qab haus huv no tseem ceeb tshwj xeeb hauv cov kab mob raum, vim tias tus mob feem ntau cuam tshuam rau ntau lub cev thiab lub cev. che tau pom tias muaj kev tiv thaiv rau lub siab, lub plawv, thiab cov hlab ntsha, uas feem ntau cuam tshuam los ntawm kab mob raum. Los ntawm kev txhawb nqa kev noj qab haus huv ntawm cov kabmob no, cistanche pab txhim kho lub raum tag nrho thiab tiv thaiv kev mob ntxiv.

Hauv kev xaus, cistanche yog cov tshuaj suav tshuaj ntsuab siv rau ntau pua xyoo los kho mob raum. Nws cov active Cheebtsam muaj diuretic, antioxidant, anti-inflammatory, immunomodulatory, thiab regenerative teebmeem, uas pab txhim kho lub raum ua haujlwm thiab tiv thaiv ob lub raum los ntawm kev puas tsuaj ntxiv. , cistanche muaj txiaj ntsig zoo rau lwm yam kabmob thiab lub cev, ua rau nws txoj hauv kev zoo rau kev kho mob raum.