摘要
目的探讨痛风患者碱化尿液治疗的效果以及影响因素,为临床治疗提供依据。方法选取2019年1月至2019年6月未行碱化尿液及降尿酸药物治疗且处于缓解期的痛风患者90例,入院后均给予低嘌呤饮食(嘌呤摄入量<200 mg/d)。根据随机数字表法分为不同碱化尿液药物组:碳酸氢钠组(服用碳酸氢钠1.0 g tid)、枸橼酸颗粒组(服用枸橼酸氢钾钠颗粒2.5 g tid)、对照组(仅继续低嘌呤饮食)。治疗第5天,留取清晨空腹尿液后,进食规定早餐,餐后服用碱化尿液药物,分别于服药后1 h、2 h、3 h、4 h留取尿液测定尿pH,比较不同碱化尿液组尿pH的变化。服药后2 h、3 h、4 h尿pH的均值以6.2为切点,将服用碱化尿液药物治疗的患者分为达标(尿pH均值≥6.2)和不达标(尿pH均值<6.2),比较影响尿pH值达标的影响因素。结果与对照组相比,碳酸氢钠组空腹尿pH值差异无统计学意义,但服用碳酸氢钠后2 h、3 h的尿pH值明显升高(P<0.05)。枸橼酸颗粒组空腹及服药后任意时间点的尿pH值均高于对照组及碳酸氢钠组(P<0.05或P<0.01)。碳酸氢钠组和枸橼酸颗粒组服药后尿pH值达峰值的时间多在服药后4 h,其次为服药后2 h或3 h。碱化尿液达标和不达标者的体重指数、腰围、血压差异有统计学意义(P<0.05或P<0.01)。结论不推荐空腹尿pH值单独作为碱化尿液疗效的判断指标,建议参考服药后2~4 h尿pH值;枸橼酸颗粒碱化尿液疗效优于碳酸氢钠;肥胖或超重是影响碱化尿液疗效的不利因素。
Objective To investigate the therapeutic effect and influencing factors of alkalized urine in patients with gout,thus providing the basis for the clinical treatmeat.Methods A total of 90 cases of gout patients in remission without alkalization of urine and lowering uric acid treatment were selected from January 2019 to June 2019.All patients were given a low purine diet(purine intake<200 mg/d).90 patients were randomly divided into different drugs of alkalized urine groups according to rardom number table:sodium bicarbonate group,taking potassium sodium hydrogen citrate 1.0 g tid;the citrate granule group,taking potassium sodium hydrogen citrate 2.5 g tid;and control group,taking low purine diet only.On the 5th day of treatment,fasting urine in the morning was retained,breakfast was prescribed,and alkalized urine drugs were taken after the meal.Their urine pH was determined at 1 h,2 h,3 h,and 4 h after the medicine taken,and copmare the changes of urine pH in different groups.Taking urine pH 6.2 as cut-off point,patients receiving alkalized urine drugs were divided into the standard group(urine pH≥6.2)and the non-standard group(urine pH<6.2)according to their mean urine pH at 2 h,3 h,and 4 h after taking medicine.Finally,the influencing factors of urine pH were compared between the groups.Results There were no significant differences in fasting urine pH between the sodium bicarbonate group and the control group,but the urine pH of 2 h and 3 h after sodium bicarbonate taken were significantly higher than the control group(P<0.05).The urine pH of the citrate granule group was higher than the control group and the sodium bicarbonate group on fasting and at any time after taking drugs(P<0.05 or P<0.01).The peak pH value of urine in the sodium bicarbonate and citrate granule groups was 4 h after taking drugs,followed by 2 h and 3 h.There were statistically significant differences in body mass index,waist circumference,and blood pressure between the standard and non-standard groups(P<0.05 or P<0.01).Conclusion Fasting urine pH alone can not be used as an index for the efficacy of alkalized urine,it is recommended to refer to the pH value of 2-4 h after taking drugs.The efficacy of potassium sodium hydrogen citrate was better than that of sodium bicarbonate.Obesity or overweight seems to be an adverse factor affecting the alkalized urine.
作者
刘甜
马利丹
程晓宇
辛颖
董沙沙
陈颖
贾兆通
孙瑞霞
Liu Tian;Ma Lidan;Cheng Xiaoyu;Xin Ying;Dong Shasha;Chen Ying;Jia Zhaotong;Sun Ruixia(Department of Endocrinology and Metabolic Diseases,the Affiliated Hospital of Qingdao University,Qingdao 266003,China)
出处
《中华内分泌代谢杂志》
CAS
CSCD
北大核心
2020年第9期761-766,共6页
Chinese Journal of Endocrinology and Metabolism
基金
国家自然科学基金青年科学基金项目(81600601)。
关键词
痛风
尿PH值
碱化
Gout
Urine pH
Alkalization
