结核病化疗药物吡嗪酰胺致高尿酸血症的危险因素研究

蒲强红; 李佳萌; 李凡敏; 袁术生

doi:10.16766/j.cnki.issn.1674-4152.002236

结核病化疗药物吡嗪酰胺致高尿酸血症的危险因素研究

doi: 10.16766/j.cnki.issn.1674-4152.002236

1.
乐山市人民医院药学部，四川乐山 614000
2.
乐山市人民医院感染性疾病科，四川乐山 614000
3.
乐山市人民医院呼吸内科，四川乐山 614000

基金项目:

四川省卫生和计划生育委员会科研课题 17PJ560

乐山市科技局重点研究项目 17SZD185

详细信息

通讯作者:
袁术生, E-mail: 1633883991@qq.com

中图分类号: R52 R978.3
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出版历程
- 收稿日期: 2021-02-04

Risk factors for tuberculosis chemotherapeutic drug pyrazinamide-induced hyperuricemia

1.
Department of Pharmacy, People's Hospital of Leshan, Leshan, Sichuan 614000, China

摘要

摘要: 目的评估结核病化疗药吡嗪酰胺致高尿酸血症的可能危险因素。方法纳入2016年7月—2020年12月期间乐山市人民医院感染性疾病科与呼吸内科确诊结核病的患者共98例，化疗强化期使用HRZE四联方案，根据强化期血尿酸水平分为高尿酸血症组(81例)与正常血尿酸组(17例)，收集年龄、性别、体重指数、吸烟史、饮酒史与慢性疾病史(糖尿病、高血压或冠心病)等资料，测定尿酸转运体URAT1与GLUT9基因多态性。结果高尿酸血症组与正常血尿酸组患者年龄、性别(男/女：50/31 vs. 8/9)、体重指数、吸烟史、饮酒史、慢性疾病史(糖尿病、高血压或冠心病：7/74 vs. 3/14)等指标比较差异无统计学意义(均P>0.05)。高尿酸血症组与正常血尿酸组肝肾功能生化指标ALT、白蛋白、总胆红素与血肌酐水平[(55.1±10.9)μmol/L vs. (58.2±12.6)μmol/L]差异无统计学意义(均P>0.05)。高尿酸血症组与正常血尿酸组URAT1基因多态性rs7932775(T1309C)、rs475688、rs3825016(C258T)的基因型比较差异无统计学意义(均P>0.05)，2组间GLUT9基因多态性rs3733591(R265H)、rs1014290的基因型差异亦无统计学意义(均P>0.05)。结论年龄、性别、体重指数、吸烟史、饮酒史、慢性疾病史(糖尿病、高血压或冠心病)、肝肾功能与URAT1、GLUT9基因多态性似乎不是结核病化疗药吡嗪酰胺致高尿酸血症的危险因素。
- 吡嗪酰胺 /
- 结核病 /
- 高尿酸血症 /
- 危险因素 /
- 基因多态性
Abstract: Objective To evaluate the possible risk factors for hyperuricemia induced by tuberculosis chemotherapeutic drug pyrazinamide. Methods Patients who were diagnosed with tuberculosis in the Department of Infection and Department of Respiratory in our hospital from July 2016 to December 2020 were enrolled. The isoniazid, rifampicin, pyrazinamide and ethambutol regimen were administrated daily in intensive period. Data of age, gender, body mass index, smoking history, drinking history and chronic disease history (diabetes, hypertension or coronary heart disease) were collected. The polymorphism of uric acid transporter URAT1 and GLUT9 gene were determined. Results No differences in age, sex(male/female: 50/31 vs. 8/9), BMI, smoking history, drinking history and chronic diseases (diabetes, hypertension or coronary heartdisease: 7/74 vs. 3/14) were found between two groups. There was no significant difference in ALT, albumin, total bilirubin and serum creatinine [(55.1±10.9)μmol/L vs. (58.2±12.6)μmol/L] in the two groups. There was no significant difference in the genotypes of URAT1 gene polymorphisms [rs7932775 (t1309c), rs475688, rs3825016 (c258t)] and GLUT9 gene polymorphisms [rs3733591 (r265h), rs1014290] between two groups (all P>0.05). Conclusion Age, sex, BMI, smoking history, drinking history, chronic diseases, hepatic and renal function, polymorphisms of URAT1 and GLUT9 gene might not be the risk factors for pyrazinamide-induced hyperuricemia.
- Pyrazinamide /
- Tuberculosis /
- Hyperuricemia /
- Risk factors /
- Gene polymorphism
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表 1 2组结核病患者流行病学资料比较

组别	例数	性别(男/女, 例)	年龄[M(P₂₅, P₇₅)，岁]	BMI[M(P₂₅, P₇₅)]	饮酒(例)	吸烟(例)	有慢性疾病(例)
正常血尿酸组	17	8/9	48.0(25.5, 56.0)	20.1(18.0, 24.9)	4	7	3
高尿酸血症组	81	50/31	37.0(26.0, 53.0)	20.3(18.7, 22.1)	10	31	7
统计量		1.252^a	602.500^b	675.500^b	0.667^a	0.050^a	0.445^a
P值		0.263	0.424	0.906	0.414	0.823	0.500
注：^a为χ²值，^b为U值。

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表 2 2组结核病患者肝肾功能生化指标比较

组别	例数	ALT[M(P₂₅, P₇₅)，U/L]	白蛋白(x±s，g/L)	总胆红素[M(P₂₅, P₇₅)，μmol/L]	血肌酐(x±s，μmol/L)
正常血尿酸组	17	24.0(17.0, 39.5)	33.2±6.9	8.3(5.2, 15.2)	55.1±10.9
高尿酸血症组	81	20.0(13.5, 33.0)	34.8±5.5	8.4(6.0, 10.7)	58.2±12.6
统计量		572.000^a	1.001^b	674.000^a	0.958^b
P值		0.278	0.320	0.895	0.340
注：^a为U值，^b为t值。

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表 3 2组结核病患者URAT1基因多态性比较(例)

组别	例数	rs7932775(T1309C)			rs3825016(C258T)			rs475688
组别	例数	TT	TC	CC	CC	CT	TT	CC	CT	TT
正常血尿酸组	17	7	8	2	10	6	1	3	12	2
高尿酸血症组	81	19	46	16	49	29	3	27	41	13
χ²值		2.393			0.171			2.334
P值		0.302			0.918			0.311

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表 4 2组结核病患者GLUT9多态性比较(例)

组别	例数	rs3733591(R265H)			rs1014290
组别	例数	CC	CT	TT	AA	AG	GG
正常血尿酸组	17	2	9	6	6	7	4
高尿酸血症组	81	13	35	33	36	34	11
χ²值		0.570			1.185
P值		0.752			0.553

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