Department of Clinical Chemistry, New Cross Hospital, Wolverhampton, West Midlands, UK.
Rheumatology (Oxford). 2013 Apr;52(4):676-8. doi: 10.1093/rheumatology/kes327. Epub 2012 Dec 19.
Acute gout is associated with a decrease in serum uric acid (SUA) that is considered to be in response to acute inflammation but it may be a feature of gout itself. We, therefore, aimed to investigate the effect of the acute systemic inflammatory response (SIR) on SUA concentrations in subjects without gout.
SUA and urinary excretion of uric acid (UA) (expressed as fractional excretion of UA; FEua%) were measured in 30 patients before and 48 h after elective knee or hip surgery. The SIR was assessed by measuring serum CRP and urine microalbumin excretion [expressed as the albumin-creatinine ratio (ACR)] before and after surgery in the same patients.
The mean (s.d.) serum CRP increased following surgery [5.0 (5.5) vs 116.0 (81.2) mg/l; P < 0.0001) as did urine ACR [0.85 (1.03) vs 2.10 (2.60) mg/mmol; P = 0.004]. SUA decreased following surgery [312 (64) vs 282 (82) µmol/l; P = 0.0033] but FEua% was unchanged [6.4 (2.3) vs 7.3 (3.3)%; P = 0.1726].
The SIR is associated with a decrease in SUA concentrations in normouricaemic patients without gout. The decrease in SUA concentrations is not due to increased urinary excretion of UA. This study supports the notion that the decrease in SUA during acute gout is due to the associated SIR rather than gout per se.
急性痛风与血清尿酸（SUA）降低有关，这种降低被认为是对急性炎症的反应，但也可能是痛风本身的特征。因此，我们旨在研究急性全身炎症反应（SIR）对无痛风患者 SUA 浓度的影响。
在 30 例接受择期膝关节或髋关节手术的患者手术前和手术后 48 小时测量 SUA 和尿酸（UA）尿排泄（表示为 UA 的分数排泄；FEua%）。通过测量同一患者手术前后的血清 CRP 和尿微量白蛋白排泄[表示为白蛋白-肌酐比（ACR）]来评估 SIR。
手术后平均（标准差）血清 CRP 增加[5.0（5.5）与 116.0（81.2）mg/l；P < 0.0001]，尿 ACR 也增加[0.85（1.03）与 2.10（2.60）mg/mmol；P = 0.004]。手术后 SUA 降低[312（64）与 282（82）µmol/l；P = 0.0033]，但 FEua% 不变[6.4（2.3）与 7.3（3.3）%；P = 0.1726]。
SIR 与无痛风的正常尿酸血症患者 SUA 浓度降低有关。SUA 浓度的降低不是由于 UA 的尿排泄增加所致。这项研究支持这样一种观点，即急性痛风期间 SUA 的降低是由于相关的 SIR 而不是痛风本身。
