Higashino K, Moriwaki Y
Third Department of Internal Medicine, Hyogo College of Medicine.
Nihon Rinsho. 1996 Dec;54(12):3364-8.
A large number of pharmacological agents affect the serum concentration of uric acid. Some drugs raise serum uric acid level by an increase in uric acid production or a decrease in uric acid excretion, while others lower serum uric acid level by a decrease in uric acid production or an increase in uric acid excretion. In addition, some drugs show so-called biphasic effect; ie, hyperuricemic in lower doses but hypouricemic in higher doses. Hyperuricemic agents contribute to gout and/or urate nephropathy. Among them, pyrazinamide is often used to determine the defective site(s) of uric acid transport in renal tubules in conjunction with uricosuric agents, such as benzbromarone or probenecid. In contrast, the clinical significance of hypouricemic agents other than uricosuric agents has not been emphasized. However, some may induce acute uric acid nephropathy by a significant increase in uric acid excretion. In this review, drugs affecting uric acid metabolism are summarized with regard to their mechanism of action and clinical significance.
大量的药物会影响血清尿酸浓度。一些药物通过增加尿酸生成或减少尿酸排泄来提高血清尿酸水平，而其他药物则通过减少尿酸生成或增加尿酸排泄来降低血清尿酸水平。此外，一些药物表现出所谓的双相效应；即，低剂量时引起高尿酸血症，而高剂量时引起低尿酸血症。高尿酸血症药物会导致痛风和/或尿酸盐肾病。其中，吡嗪酰胺常与促尿酸排泄药物（如苯溴马隆或丙磺舒）联合使用，以确定肾小管中尿酸转运的缺陷部位。相比之下，除促尿酸排泄药物外的其他低尿酸血症药物的临床意义尚未得到重视。然而，一些药物可能会因尿酸排泄显著增加而诱发急性尿酸肾病。在这篇综述中，将从作用机制和临床意义方面对影响尿酸代谢的药物进行总结。
