Ellis E N, Brouhard B H, Conti V R
Ann Thorac Surg. 1983 Aug;36(2):167-72. doi: 10.1016/s0003-4975(10)60451-1.
Because we sometimes observed large amounts of uric acid crystals in the urine of infants and children after open-heart operations and since renal insufficiency from any cause can be a serious complication of cardiac procedures, 8 acyanotic and 5 cyanotic children were studied prospectively by comparing several preoperative and postoperative measures of renal function. There were no significant differences between the acyanotic and cyanotic groups in terms of age, time on cardiopulmonary bypass, or other preoperative variables. Postoperatively, children in both groups had a wide range of free water clearances (CH2O), with some values in the range reported to be diagnostic of renal insufficiency in adults. Since none of these children had renal insufficiency by other criteria, CH2O may not be as reliable an indicator of renal insufficiency in children. The major difference between the cyanotic and acyanotic groups was seen in postoperative serum uric acid levels (SUA); the mean SUA levels in the acyanotic and cyanotic groups were 5.3 +/- 0.5 mg/dl (+/- standard error of the mean) and 10.4 +/- 1.7 mg/dl (range, 8.0 to 15.5 mg/dl), respectively. Since the hyperuricemia in the cyanotic children could not be related to increased exogenous administration or decreased renal excretion, it is probably caused by increased endogenous production and may be related to the resolution of the cyanotic state.
因为我们有时在婴幼儿心脏直视手术后的尿液中观察到大量尿酸结晶，且由于任何原因导致的肾功能不全都可能是心脏手术的严重并发症，所以我们对8名非紫绀型和5名紫绀型儿童进行了前瞻性研究，比较了术前和术后的几项肾功能指标。非紫绀型和紫绀型组在年龄、体外循环时间或其他术前变量方面无显著差异。术后，两组儿童的自由水清除率（CH2O）范围很广，有些值在据报道可诊断成人体肾功能不全的范围内。由于这些儿童按其他标准均无肾功能不全，所以CH2O可能不是儿童肾功能不全的可靠指标。紫绀型和非紫绀型组的主要差异在于术后血清尿酸水平（SUA）；非紫绀型组和紫绀型组的平均SUA水平分别为5.3±0.5mg/dl（±平均标准误差）和10.4±1.7mg/dl（范围为8.0至15.5mg/dl）。由于紫绀型儿童的高尿酸血症与外源性给药增加或肾排泄减少无关，所以可能是内源性生成增加所致，且可能与紫绀状态的缓解有关。
