Hiroshige K, Takasugi M, Yuu K, Kuroiwa A
2nd Department of Internal Medicine, School of Medicine, University of Occupational and Environmental Health Kitakyushu city, Fukuoka, Japan.
Nihon Jinzo Gakkai Shi. 1994 Nov;36(11):1268-75.
The effect of drugs that alter the renal tubular transport of urate in the renal excretion of the oxypurines, hypoxanthine (Hx) and xanthine (X), was used to analyze the tubular mechanisms involved in oxypurine excretion in normal subjects and in patients with idiopathic renal hypouricemia. In healthy subjects, administration of the drugs, benzbromarone (Bb) and probenecid (Pb), brought a marked uricosuric effect, but did not alter oxypurine excretion. One of 2 hypouricemic patients exhibited no uricosuric effects with Bb and the other showed a slight uricosuric effect with the drug. Bb administration, however, produced no increase in oxypurine excretion in either patient. In healthy subjects, administration of pyrazinamide (PZA) suppressed the excretion of urate and oxypurines to varying degrees: relative to the baseline values, the fraction excretion of urate was reduced by 95% or more, that of Hx by about 24%, and that of X by about 64%. In patients with hypouricemia, the effects of PZA on urate and oxypurine excretion were impaired. According to these findings, we can speculate that the oxypurines have the same renal secretory mechanism as uric acid. However, the reabsorptive mechanisms of oxypurines at the postsecretory site are likely to differ from that of uric acid.
改变尿酸盐在肾小管转运的药物对氧嘌呤（次黄嘌呤，Hx和黄嘌呤，X）肾排泄的影响，被用于分析正常受试者和特发性肾性低尿酸血症患者中氧嘌呤排泄所涉及的肾小管机制。在健康受试者中，给予苯溴马隆（Bb）和丙磺舒（Pb）这两种药物可产生显著的促尿酸尿作用，但不改变氧嘌呤排泄。两名低尿酸血症患者中，一名对Bb无促尿酸尿作用，另一名对该药物有轻微促尿酸尿作用。然而，给予Bb后，两名患者的氧嘌呤排泄均未增加。在健康受试者中，给予吡嗪酰胺（PZA）可不同程度地抑制尿酸盐和氧嘌呤的排泄：相对于基线值，尿酸盐的排泄分数降低95%或更多，Hx降低约24%，X降低约64%。在低尿酸血症患者中，PZA对尿酸盐和氧嘌呤排泄的作用受损。根据这些发现，我们可以推测氧嘌呤与尿酸具有相同的肾分泌机制。然而，氧嘌呤在分泌后部位的重吸收机制可能与尿酸不同。
