Department of Internal Medicine, KMCT Medical College Manassery, Calicut, 673602, Kerala, India.
Clin Rheumatol. 2017 Dec;36(12):2637-2644. doi: 10.1007/s10067-017-3851-y. Epub 2017 Oct 4.
Whether to treat hyperuricemia uncomplicated by articular gout, urolithiasis, or uric acid nephropathy is an exercise in clinical judgment and universal agreement is lacking. Patients with coronary artery disease, chronic kidney disease, and early onset hypertension with persistent hyperuricemia are likely to be benefited with urate-lowering therapy. The paradigm of the causative association of hyperuricemia with cardiovascular and chronic kidney diseases seems to have progressed from skepticism to increasing evidence of a true relationship. Although such evidences are mounting, they are not enough to support pharmacotherapy for all patients with asymptomatic hyperuricemia. Further studies are needed to determine which patients are likely to get beneficial effects from pharmacotherapy and the minimum threshold of uric acid level required to experience clinical benefits.
是否治疗单纯性关节痛风、尿路结石或尿酸肾病所致高尿酸血症，是一个临床判断问题，目前尚未达成普遍共识。伴有冠状动脉疾病、慢性肾脏病、伴有持续性高尿酸血症的早发高血压的患者，降尿酸治疗可能获益。高尿酸血症与心血管和慢性肾脏病之间因果关系的范例似乎已从怀疑演变为越来越多的真实关系证据。尽管这些证据不断增加，但仍不足以支持对所有无症状高尿酸血症患者进行药物治疗。需要进一步研究以确定哪些患者可能从药物治疗中获得益处，以及获得临床益处所需的尿酸水平最低阈值。
