Gadomska-Prokop K, Konopielko Z
Klinika Nefrologii i Nadciśnienia Tetniczego Instytutu Pomnika-Centrum Zdrowia Dziecka.
Pol Merkur Lekarski. 2000 Apr;8(46):177-8.
We treated 39 children with hyperuricosuria (18 boys and 21 girls aged between 6 and 11 years). Treatment consisted of increased fluid intake, low salt and low purine diet and urine alkalization up to pH 6.5-6.8. We have selected two groups of patients with different uric acid [UA] metabolism parameters. In group I (21 children) mean value of serum UA was 2.52 mg/dL, mean urine UA excretion was 13.11 mg/kg/d and UA FE was 21.51%. In group II (18 children) mean value of serum UA was 4.7 mg/dL, mean urine UA excretion was 12.8 mg/kg/d and UA FE was 10.9%. In group I, treatment did not normalize uricosuria (13.57 mg/kg/d), urine pH was elevated (6.56). In group II uricosuria was diminished (8.37 mg/kg/d), urine pH was 6.37. 1. Disturbances of tubular secretion may be suspected in some children with hyperuricosuria and without hypouricemia. 2. The maintenance of urine pH within normal values is the basic of treatment in children with hyperuricosuria. 3. In children suspected of tubular transport disturbances appropriate tests of uric acid metabolism should be performed.
我们对39名高尿酸尿症儿童（18名男孩和21名女孩，年龄在6至11岁之间）进行了治疗。治疗措施包括增加液体摄入量、低盐和低嘌呤饮食以及将尿液碱化至pH值6.5 - 6.8。我们选择了两组尿酸[UA]代谢参数不同的患者。第一组（21名儿童）血清UA的平均值为2.52mg/dL，平均尿UA排泄量为13.11mg/kg/d，UA FE为21.51%。第二组（18名儿童）血清UA的平均值为4.7mg/dL，平均尿UA排泄量为12.8mg/kg/d，UA FE为10.9%。在第一组中，治疗未能使高尿酸尿症正常化（13.57mg/kg/d），尿液pH值升高（6.56）。在第二组中，高尿酸尿症有所减轻（8.37mg/kg/d），尿液pH值为6.37。1. 对于一些高尿酸尿症且无低尿酸血症的儿童，可能怀疑存在肾小管分泌障碍。2. 将尿液pH值维持在正常范围内是高尿酸尿症儿童治疗的基础。3. 对于怀疑有肾小管转运障碍的儿童，应进行适当的尿酸代谢检查。
