Them mloog mus rau Kev kuaj mob thiab kev kho mob ntawm hyperuricemia hauv raum kab mob!

Hyperuricemia tuaj yeem ua rau muaj kev loj hlob ntawm cov kab mob hauv lub raum thiab qhov tshwm sim ntawm cov teeb meem ntawm cov hlab plawv thiab cerebrovascular thiab yog ib qho kev pheej hmoo ywj pheej uas ua rau muaj kev tshwm sim thiab kev loj hlob ntawm cov kab mob raum ntev (CKD), kab mob plawv thiab cerebrovascular, thiab kab mob metabolic. Kab mob raum yog ib qho tseem ceeb ua rau hyperuricemia, thiab hyperuricemia kuj yog ib qho teeb meem ntawm CKD. Ob qho tib si cuam tshuam rau ib leeg thiab hem lub neej thiab kev noj qab haus huv ntawm cov neeg mob. Yog li ntawd, kev kho mob yuav tsum tau them sai sai rau kev kuaj mob thiab kev kho mob ntawm hyperuricemia hauv lub raum kab mob.

Nyem rau Cistanche rau mob raum

1. Kev sib raug zoo ntawm hyperuricemia thiab kab mob raum

Cov kev tshawb fawb tau pom tias hyperuricemia tsis yog tsuas yog muaj kev pheej hmoo txaus ntshai rau qhov pib tshiab ntawm CKD tab sis kuj yog ib qho kev pheej hmoo ywj pheej rau nws txoj kev loj hlob. Nws tshwj xeeb manifestations yog raws li nram no.

(1) Rau txhua txhua 60 μmol / L nce hauv cov ntshav uric acid, qhov kev pheej hmoo ntawm kab mob raum nce los ntawm 7% mus rau 11%, thiab kev pheej hmoo ntawm lub raum ua haujlwm tsis zoo nce 14%.

(2) Piv nrog rau cov neeg uas muaj cov ntshav uric acid ib txwm muaj, cov neeg uas muaj ntshav uric acid nyob nruab nrab ntawm 420 thiab 534 μmol / L muaj 2-fold nce kev pheej hmoo ntawm cov kab mob raum tshiab, thaum cov neeg muaj ntshav uric acid ntau dua los yog sib npaug li 540 μmol / L muaj kev pheej hmoo ntawm cov kab mob raum tshiab. mus 3x.

(3) Qhov kev pheej hmoo ntawm kev tsim cov kab mob hauv lub raum theem kawg nce 4 zaug thiab 9 npaug ntawm cov txiv neej uas muaj ntshav uric acid ntau dua lossis sib npaug li 420 μmol / L thiab cov poj niam siab dua lossis sib npaug li 360 μmol / L.

(4) Cov neeg mob CKD theem 3 txog 5 nrog hyperuricemia muaj kev pheej hmoo siab ntawm kev mob raum sai thiab xav tau kev kho lub raum.

(5) Rau txhua txhua 60 μmol / L nce hauv cov ntshav uric acid theem hauv cov neeg mob CKD theem 3 txog 4, qhov kev pheej hmoo ntawm cov hlab plawv tuag nce 16%, thiab kev pheej hmoo ntawm txhua qhov ua rau tuag nce 17%.

Nws tuaj yeem pom los ntawm cov saum toj no tias hyperuricemia muaj qhov cuam tshuam loj dua rau qhov tshwm sim thiab kev loj hlob ntawm CKD. Thaum cov neeg mob hyperuricemia pom nyob rau hauv kev kho mob, yuav tsum tau saib xyuas.

2. Yuav kuaj mob hyperuricemia hauv lub raum li cas?

Kev kuaj mob raum kab mob hyperuricemia yuav tsum tau ua raws li cov txheej txheem kuaj mob rau CKD thiab hyperuricemia feem, raws li cov lus qhia hauv qab no.

1. CKD diagnostic cov txheej txheem [1]: (1) Lub raum puas (qhov txawv txav ntawm lub raum qauv lossis kev ua haujlwm) rau ntau dua lossis sib npaug li 3 lub hlis, nrog lossis tsis muaj qhov txo qis ntawm kwv yees glomerular filtration rate (eGFR), txawv txav rau lub raum pathological kuaj lossis raum. kev puas tsuaj (cov ntshav txawv txav, cov zis tso zis lossis kev kuaj pom). (2) eGFR<60 ml/(min·1.73m2) ≥3 months, with or without evidence of kidney damage.

2.[2]: The definition of hyperuricemia is divided into biochemical definition and epidemiological definition. The "Practical Guidelines for the Diagnosis and Treatment of Hyperuricemia in Kidney Disease in China (2017 Edition)" recommends the use of epidemiological definitions, that is, under a normal purine diet, fasting blood uric acid in men and postmenopausal women on two separate occasions on different days is >420 μmol/L, Non-menopausal women >360 μmol / L.

3. Txoj Cai Kho Mob ntawm Hyperuricemia hauv Kab Mob raum

1. Kev tswj kev ua neej kom zoo: zam kom tsis txhob noj cov zaub mov muaj purine xws li tsiaj txhu, thiab tswj kev noj cov nqaij, nqaij nruab deg, taum, thiab lwm yam khoom noj; haus dej ntau dua thiab tsis txhob haus dej cawv thiab fructose-nplua nuj; noj cov zaub mov uas tsis muaj ntsev thiab ib ce tsis tu ncua.

2. Kev tshuaj xyuas kev tiv thaiv: Kev tshuaj ntsuam xyuas dav dav thiab kev tswj xyuas cov kab mob plawv muaj feem cuam tshuam nrog hyperuricemia, suav nrog kev kub siab, ntshav qab zib, hyperlipidemia, thiab lwm yam.

3. Kev siv tshuaj raws cai: Tsis txhob siv cov tshuaj uas tuaj yeem nce ntshav uric acid, suav nrog thiazides thiab voj diuretics, qee yam tshuaj tiv thaiv kab mob, cov tshuaj salicylates qis, thiab qee yam tshuaj hypoglycemic (sulfonamides thiab biguanides). cov tshuaj hypoglycemic), thiab lwm yam.

4. Tsim nyog alkalinization ntawm cov zis: tso zis pH 6.2 txog 6.9 yog qhov tsim nyog rau kev sib cais thiab tshem tawm cov zis muaju los ntawm cov zis. Cov zis pH > 7.0 yog nquag tsim cov calcium oxalate thiab lwm hom pob zeb.

4. Tshuaj kho mob hyperuricemia nyob rau hauv lub raum kab mob

1. Kev kho mob hyperuricemia hauv cov neeg mob uas tsis tau lim ntshav

(1) Cov tshuaj uas inhibit uric acid ntau lawm: ① Allopurinol. Nws raug nquahu kom pib kho nrog koob tshuaj tsawg, feem ntau 100 mg / d, thiab maj mam nce koob kom ua tiav lub hom phiaj ntawm cov ntshav uric acid. Kev noj tshuaj yuav tsum raug kho raws li eGFR. ②Febuxostat. Qhov pom zoo pib koob tshuaj yog 20 mus rau 40 mg / d. Yog tias cov tshuaj uric acid tsis tuaj yeem ncav cuag lub hom phiaj tom qab 2 mus rau 4 lub lis piam, koob tshuaj tau nce 20 mg / d, nrog rau qhov siab tshaj plaws yog 80 mg / d.

(2) Cov tshuaj uas txhawb nqa uric acid excretion: cov tshuaj sawv cev yog benzbromarone. Cov koob tshuaj pom zoo rau cov neeg mob uas lub raum ua haujlwm tsis zoo yog 50 txog 100 mg / d, thiab rau cov neeg uas muaj eGFR 30 txog 60 ml / (min·1.73m2), qhov pom zoo koob tshuaj yog 50 mg / d. Siv ceev faj thaum eGFR tsawg dua 30 ml / (min·1.73 m2). Nws yog contraindicated rau lub raum pob zeb thiab mob uric acid nephropathy.

(3) Rau cov tshuaj txo qis uric acid tshiab: xws li topimastat, koob tshuaj pib rau cov neeg laus yog 20 mg / zaug, ob zaug / d, thiab qhov siab tshaj plaws yog 80 mg / zaug, ob zaug / d. Cov tshuaj yog metabolized los ntawm lub siab thiab muaj kev ruaj ntseg rau lub raum.

(4) Lwm cov tshuaj uric acid txo qis: xws li losartan, sodium-glucose cotransporter 2 inhibitors, thiab lwm yam.

2. Kev kho mob hyperuricemia hauv cov neeg mob hemodialysis

(1) Allopurinol: Dialysis cov neeg mob uas yuav tsum tau siv cov tshuaj uric acid txo qis tuaj yeem xaiv siv allopurinol. Rau cov neeg mob hemodialysis tsis tu ncua, koob tshuaj pib ntawm allopurinol yog 100 mg txhua hnub, tom qab lim ntshav. Cov neeg mob hemodialysis txhua hnub yuav tsum tau txais 50% ntxiv ntawm allopurinol tom qab lim ntshav.

(2) Febuxostat: Nws raug pom zoo tias cov neeg mob hemodialysis noj thawj koob tshuaj febuxostat ntawm 5 txog 10 mg / d. Cov qib uric acid hauv cov ntshav yuav raug tshuaj xyuas tom qab 2 lub lis piam los txiav txim seb qhov koob tshuaj yuav tsum tau kho li cas. Feem ntau, qhov siab tshaj plaws yog 40 mg / d.

(3) Pegolase: Rau cov neeg mob lim ntshav thiab cov neeg uas lub raum ua haujlwm tsis zoo, qhov pib koob tshuaj pegolase yog 8 mg intravenously txhua ob lub lis piam, thiab qhov siab tshaj plaws yog 8 mg intravenously txhua ob lub lis piam.

(4) Kev ceev faj: Benzbromarone, lesinurad, probenecid, thiab sulfasalazine raug txwv rau cov neeg mob hemodialysis.

3. Kev kho mob hyperuricemia nyob rau hauv cov neeg mob peritoneal dialysis

(1) Treatment timing: For peritoneal dialysis patients with hyperuricemia, the treatment timing is >420 μmol/L for men and >360 μmol / L rau cov poj niam, uas yog, thaum uric acid ntau tshaj qhov qub, kev kho uric acid-txo qis yog pib, thiab cov ntshav uric acid yog tswj tau mus ntev.<360 μmol/L.

(2) Txhim kho qhov txaus ntawm peritoneal dialysis.

(3) Tiv thaiv lub raum tsis ua haujlwm.

(4) Kev kho tshuaj muaj xws li febuxostat, allopurinol, thiab losartan.

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 rauraumnoj 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.