目的 探讨不同类型尿结石患者肠道菌群结构与尿酸代谢的相关性研究。方法 随机选取2022年5月—2023年5月广州市第一人民医院泌尿外科住院的尿结石患者60例为研究组, 选取同期体检中心健康体检人群30名为对照组,按照结石成分将研究组患者分为尿酸组和非尿酸组, 每组各30例, 所有入选患者均接受结石样本、尿样本、大便样本、血样本的采集, 所有样本经光谱、质谱、基因测序、尿常规及血生化检测 , 比较入选对象的肠道菌群及血尿生化指标变化。结果 尿酸组和非尿酸组患者的血磷（SNK-q=7.970、3.542）、血BUN（SNK-q=5.647、4.756）、血SUA（SNK-q=8.178、3.623）、血SCr（SNK-q=7.300、5.553）、血LPS（SNK-q=13.101、9.705）及24h尿酸（SNK-q=4.462、6.426）水平均高于对照组, 具有统计学意义（P<0.05）, 尿酸组和非尿酸组患者的血钙水平低于对照组（SNK-q=3.918/3.047, P<0.05）。非尿酸组患者的血磷、血SUA、血LPS均低于尿酸组, 均有统计学意义（SNK-q=4.428、4.555、3.397, P<0.05）。尿酸组和非尿酸组患者肠道中双歧杆菌数量低于对照组, 差异具有统计学意义（SNK-q=3.754、3.143, P<0.05）。非尿酸组患者肠道中乳酸杆菌数量高于对照组和尿酸组（SNK-q=4.105、3.463, P<0.05）, 尿酸组及非尿酸组患者的血尿酸及24 h尿尿酸水平与肠道双歧杆菌数量呈负相关（P<0.05）。结论 肠道双歧杆菌数量对结石患者血尿酸代谢及尿结石形成具有相关性。

Objective To explore the relationship of intestinal flora and uric acid metabolism in different urinary stones patients．Methods From May 2022 to May 2023, 60 patients with urinary stones patients in Guangzhou First People’s Hospital were selected as the study group, and 30 health check-up people in the same period of the medical examination center were selected as the control group．Study group was divided into the uric acid group and the non-uric acid group, 30 cases each group, all patients received stone samples, urine samples, stool samples,blood samples collection, mass spectrometry, gene sequencing, urine routine, blood biochemical detection were performed．Intestinal flora and blood urinary biochemical indicators of the patients were compared．Results The levels of blood phosphorus（SNK-q=7.970, 3.542）, blood BUN（SNK-q=5.647, 4.756）, blood SUA （SNK-q=8.178, 3.623）, blood SCr（SNK-q=7.300, 5.553）, blood LPS（SNK-q=13.101, 9.705）, and 24-hour urine uric acid （SNK-q=4.462, 6.426）in the uric acid group and the non-uric acid group were all higher than those in the control group,and were statistically significant（P<0.05）．The blood calcium levels of the patients in the uric acid group and the non-uric acid group were lower than those in the control group（SNK-q=3.918/3.047, P<0.05）．The blood phosphorus, blood SUA and blood LPS levels of the non-uric acid group were all lower than those of the uric acid group, and the differences were statistically significant （SNK-q=4.428, 4.555, 3.397, P<0.05）．The number of bifidobacteria in the intestines of patients in the uric acid group and the non-uric acid group was lower than that of the control group,and the differences were statistically significant（SNK-q=3.754, 3.143, P<0.05）．The number of lactobacilli in the intestines of patients in the non-uric acid group was higher than that of the control group and the uric acid group（SNK-q=4.105, 3.463, P<0.05）．The levels of blood uric acid and 24-hour urine uric acid in the uric acid group and the non-uric acid group were negatively correlated with the number of Bifidobacterium in the intestines（P<0.05）．Conclusions The number of intestinal bisidobacteria has a significant correlation with the metabolism of blood uric acid and urinary stones in patients with stones．

目的 研究高尿酸（UA）和肥胖的交互作用对非酒精性脂肪肝病（NAFLD）患病率的影响。方法 采用病例对照的研究法,选取2021年1月至2021年12月兰州市某医院健康体检中心进行常规健康体检的504人为研究对象,按照诊断标准分为NAFLD组187人和非NAFLD 组317人。采用Logistic 回归模型、相乘、相加交互模型探讨非酒精性脂肪肝病患病风险的影响因素及因素间的交互作用。结果 多因素条件Logistic回归分析可知,肥胖（OR=4.87,95%CI：3.01~7.89）,糖尿病患者（OR=3.40,95%CI：1.51~7.68）,幽门螺杆菌（Hp）携带者（OR=1.62,95%CI：1.03~2.57）,高尿酸血症的NAFLD患病风险增加,分别是正常者、非糖尿病患者、非Hp携带者,非高尿酸血症的4.87倍,3.40倍,1.62倍,2.28倍,在调整混杂因素后交互作用结果显示,高尿酸血症和肥胖对NAFLD患病率有相乘交互作用（OR=0.30,95%CI：0.10~0.88,P=0.029）、但无相加交互作用（相对超额危险度比=3.15、归因比=0.24、协同指数=1.34）。结论 BMI、糖尿病、Hp是NAFLD患病的独立危险因素,其中高尿酸血症和超重与肥胖对NAFLD患病有相乘交互作用,无相加交互作用。

Objective To explore the influence of the interaction of high uric acid（UA）and obesity on the prevalence of non-alcoholic fatty liver disease（NAFLD）．Methods Using a case-control study method,504 people who underwent routine health checkups at the health checkup centre of a hospital in Lanzhou City from January 2021 to December 2021 were enrolled in the study,and 187 people were included in the NAFLD group and 317 people in the non-NAFLD group according to the diagnostic criteria．Logistic regression models,multiplicative and additive interaction models were used to investigate the factors affecting the risk factors of NAFLD and the interaction between the factors．Results Multifactorial conditional logistic regression analysis showed that the risk of NAFLD was increased in obese（OR=4.87,95% CI：3.01-7.89）,diabetic patients（OR=3.40,95% CI：1.51-7.68）,Helicobacter pylori（Hp）carriers（OR=1.62,95% CI：1.03-2.57）;the increased risk of NAFLD prevalence in hyperuricaemia patients was 4.87,3.40,1.62,and 2.28 times higher than that of normal,non-diabetic,non-Hp carriers,and non-hyperuricemic individuals,respectively．And the adjusted interaction showed a multiplicative interaction of hyperuricaemia and obesity on the prevalence of NAFLD after controlling for the confounders（OR=0.30,95% CI：0.10-0.88,P=0.029）,but no additive interaction （relative excess risk due to interaction=3.15,attributable proportion due to interaction=0.24,and synergy index=1.34） interactions．Conclusions BMI,diabetes mellitus,and Hp were independent risk factors for the prevalence of NAFLD,with hyperuricaemia and overweight and obesity having multiplicative interaction and no additive interaction．

目的 观察中等强度有氧运动联合力量训练对老年高尿酸血症(HUA)尿酸、身体机能及生活质量影响分析。方法 2019年1月—2019年12月在我社区收治的老年HUA患者60例纳入研究,随机数字表法进行分组,选取其中的30例患者实施常规饮食、运动指导为对照组,另30例患者配合中等强度有氧运动联合力量训练为研究组。比较2组患者对干预的依从性,干预前、后的血尿酸水平,身体机能及生活质量评分(WHOQOL-100评分)。结果 2组患者均在干预期内完成训练,依从性优良率比较,差异无统计学意义(P＞0.05)。干预前2组患者的血尿酸水平、身体机能比较,差异无统计学意义(P＞0.05)。干预后2组患者的血尿酸水平、安静心率较干预前降低,研究组低于对照组,而肺活量则较干预前提升,研究组高于对照组,差异有统计学意义(P＜0.05)。干预前2组患者的WHOQOL-100评分比较,差异无统计学意义(P＞0.05),干预后2组WHOQOL-100各项评分较干预前提升,研究组高于对照组,差异有统计学意义(P＜0.05)。结论 在老年HUA患者的相关指导中,运用中等强度有氧运动联合力量训练的运动干预,可较为明显的降低血清血尿酸水平,降低并平稳安静心率,提升肺活量,提升生活质量,效果理想。

Objective To observe the effect of moderate intensity aerobic exercise combined with strength training on uric acid level, physical function and quality of life in elderly patients with hyperuricemia (HUA). Methods Sixty elderly patients with HUA were treated in our center from January 2019 to December 2019. They were randomly divided into two groups, 30 cases in each group. Among them, 30 cases given routine diet and exercise guidance were included in control group, and the other 30 cases given moderate intensity aerobic exercise combined with strength training on the basis of the control group were included in study group. The compliance, blood uric acid level, physical function and quality of life (WHOQOL-100 scores) before and after the intervention were compared between the two groups. Results Two groups of patients completed the training within the expected time, and there was no significant difference in compliance (P＞0.05). Before the intervention, there were no significant differences in blood uric acid level and physical function between the two groups (P＞0.05). After the intervention, the serum uric acid level and resting heart rate of the two groups were lower than those before the intervention, and those of the research group were even lower than the control group, while the vital capacity was higher than that before the intervention, and the research group was higher than the control group, those differences were significant (P＜0.05). Before the intervention, there was no significant difference in WHOQOL-100 score between the two groups (P＞0.05). After the intervention, the scores of WHOQOL-100 in the two groups were higher than those before the intervention, and that in the study group was higher than the control group (P＜0.05). Conclusions In the relevant guidance of elderly patients with hyperuricemia (HUA), the application of moderate intensity aerobic exercise combined with strength training can significantly lower the serum uric acid level, reduce and stabilize the resting heart rate, improve the vital capacity and quality of life, with ideal effect.

目的 探究冠心病患者实施血清胆红素与尿酸检验的临床诊断价值。方法 遴选时段2020年6月—2021年6月内100例冠心病患者记观察组,另择取同时段健康体检对象100例记对照组,检测血清胆红素、尿酸水平并2组相对比,同时观察组患者根据冠脉狭窄程度(Gensini法)分组为A、B、C、D组,比较冠脉不同狭窄程度分级下上述指标的变化;评估对比血清胆红素、尿酸单项指标检验与联合检验对冠心病患者的诊断效能。结果 观察组较对照组血清胆红素(总胆红素、直接胆红素、间接胆红素)水平更低,尿酸水平更高,对比有统计学差异(P＜0.05);随着冠脉狭窄程度越严重患者血清胆红素水平呈下降趋势,尿酸水平呈升高趋势,且4组组间比较均差异有统计学意义(P＜0.05);冠心病患者血清胆红素联合尿酸检验的诊断敏感度96.00%、特异度95.00%均高于单项检验敏感度及特异度(P＜0.05)。结论 血清胆红素与尿酸水平可作为冠心病患者诊断的敏感性指标,其与冠心病的发生及发展密切相关,可反映患者病情严重程度,且联合检验诊断价值更高。

Objective To explore the clinical diagnostic value of serum bilirubin and uric acid detection in patients with coronary heart disease. Methods A total of 100 patients with coronary heart disease from June 2020 to June 2021 were selected as the observation group, and another 100 healthy subjects in the same period were selected as control group. Serum bilirubin and uric acid levels were detected and compared between the two groups. Meanwhile, the patients in the observation group were divided into groups A, B, C and D according to the degree of coronary artery stenosis (Gensini method). The changes of the above indexes were compared among different grades of coronary stenosis. And the diagnostic efficacy of each single detection and combined detection of serum bilirubin and uric acid in patients with coronary heart disease were evaluated and compared. Results Compared with the control group, the serum bilirubin (total bilirubin, direct bilirubin, indirect bilirubin) level of the observation group was lower, and the uric acid level was higher, with statistical differences (P<0.05). With the increased severity of coronary artery stenosis, the serum bilirubin level of patients showed a downward trend, while the uric acid level showed an upward trend, and there were significant differences among the four groups (P<0.05). The sensitivity and specificity of serum bilirubin combined with uric acid detection in patients with coronary heart disease were 96.00% and 95.00% respectively, which were higher than those of single detection (P<0.05). Conclusions Serum bilirubin and uric acid levels can be used as sensitive indicators in the diagnosis of patients with coronary heart disease, and are closely related to the occurrence and development of coronary heart disease, which can reflect the severity of the disease, also the diagnostic value of combined detection is higher.

目的 探索2型糖尿病(T2DM)男性患者血尿酸水平与骨密度(BMD)、临床骨折患病率的相关性。方法 选取广州市第一人民医院住院的T2DM男性患者192例,采用双能X线骨密度仪测定各部位BMD,记录年龄、糖尿病病程、BMI,检测血尿酸、空腹血糖、糖化血红蛋白、血脂、碱性磷酸酶等,并分析BMD与其余指标的相关性。结果 骨质疏松组血尿酸、各部位BMD均低于骨量正常组及低骨量组(P＜0.05)。血尿酸与各部位BMD正相关(P＜0.01)。右股骨颈BMD与年龄负相关,与空腹血糖正相关(P＜0.05)。多元Logistic回归分析显示,血尿酸与临床骨折呈负相关。调整年龄、空腹血糖、ALP等混杂因素后,血尿酸水平与临床骨折仍有关联。当进一步调整各部位BMD时,结果无统计学意义。结论 维持正常稍高的血尿酸水平可能有利于减少T2DM男性患者骨质疏松及脆性骨折的发生。

Objective To explore the correlation in serum uric acid level and bone mineral density (BMD) and fracture rate in male patients with type 2 diabetes mellitus (T2DM). Methods 192 cases of male patients with T2DM in Guangzhou First People's Hospital were selected in this study.BMD was measured by bone density machine. The patient's age, diabetes course and BMI were recorded. Fasting blood glucose, glycated hemoglobin (HbA1c), liver and kidney function, blood uric acid, blood lipid, alkaline phosphatase, 25 hydroxyvitamin D3 levels were measured, and the correlation between BMD and other indicators was analyzed. Results The serum uric acid level,lumbar and right femoral neck BMD in the osteoporosis group were lower than those in the normal and low bone mass groups (P<0.05). Serum uric acid was positively correlated with BMD values of lumbar spine and right femoral neck in male patients with type 2 diabetes (P<0.01). BMD value of right femoral neck was negatively correlated with age and positively correlated with fasting blood glucose (P<0.05). Multivariate logistic regression analysis showed a significant negative correlation between serum uric acid and clinical fractures in male patients with type 2 diabetes (model 1). When the model was adjusted for age, fasting blood glucose, ALP and other factors, serum uric acid levels were still associated with clinical fractures (model 2). When the BMD values of the lumbar spine and the right femoral neck were further included (model 3), the results were not statistically significant. Conclusion Slightly higher blood uric acid levels may help to reduce the incidence of OP and fracture rate in male patients with T2DM.

目的 探讨血清胱抑素C、尿酸及降钙素原对诊断急性心肌梗死的临床价值。方法 回顾性分析我院134例心肌梗死患者及89名健康人血清胱抑素C、尿酸及降钙素原水平。结果 与健康对照组相比,实验组患者血清Cys-C、UA和PCT均有不同程度的升高,且差异有统计学意义。此外,血清Cys-C和PCT升高的水平与心肌梗死程度有关。结论 血清Cys-C、UA和PCT水平均可以作为AMI的临床指标,并且血清Cys-C和PCT在一定程度反映心肌梗死的严重程度。

目的 探讨中青年医护人员血尿酸(UA)水平与心血管危险因素的关系。方法 利用国人缺血性心血管疾病发病危险的评估方法及简易评估工具“心血管危险积分”评价982名中青年医护人员的心血管危险因素,计算其危险评分积分值,用四分位法根据UA值将研究对象分为四组,比较不同分组间的临床资料,分析UA水平与心血管危险因素的关系。结果 UA水平与心血管危险因素存在正相关(P＜0.01);Ⅲ、Ⅳ组心血管危险积分均高于Ⅰ、Ⅱ组,差异有统计学意义(P＜0.01)。结论 UA增高是心血管疾病的一个重要危险因素,重视高尿酸血症的防治,对预防中青年医护人员的心血管疾病的发生具有重要意义。

Objective To study the relationship between serum uric acid levels and risk factor of cardiovascular disease in young and middle-aged medical staff. Methods Using of risk assessment method and simple assessment tools of cardiovascular risk score of Chinese ischemic cardiovascular disease, the study appraised risk factors of cardiovascular disease about 982 young and middle-aged medical staffs, calculated the risk score integral value. The study divided objects of study into four groups with quartile's method according to serum uric acid levels, compared clinical data between different groups, analyzed the correlation between uric acid level and cardiovascular risk factors. Results Serum uric acid level and cardiovascular risk factors had positive correlation(P<0.01); Ⅲ,Ⅳ group's cardiovascular risk score were higher than Ⅰ, Ⅱ group; the difference had statistics significance(P<0.01). Conclusion Hyperuricemia is an important risk factors in cardiovascular disease. Paying attention to hyperuricemia prevention has important significance to prevention of cardiovascular disease in young and middle-aged medical staff.

目的 探讨老年人血尿酸(serum uric acid,SUA)水平与阿尔茨海默病(Alzheimer's disease,AD)的相关性。方法 选择227例我院老年病科住院患者为研究对象,其中阿尔茨海默病67例,其余160例为非AD组。收集病史、吸烟史、服药史,并检测血尿酸、总胆固醇(TC)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)、高密度脂蛋白胆固醇(HDL-C)、空腹血糖(FBS)、血肌酐(Cr)水平。比较各SUA四分位数水平AD的发生率,并进行相关性分析。结果 AD组血尿酸水平低于非AD组,差异有统计学意义(P＜0.01);多因素分析筛选出年龄、性别、缺血性脑卒中是危险因素(P＜0.05),而服用他汀、SUA、HDL-C是保护因素(P＜0.05)。对AD和SUA的四个分组做Spearman等级相关分析(rs=-0.285,P<0.001),结果呈等级负相关。结论 血尿酸水平与老年人AD相关,血尿酸可能是AD发病的保护性因素。

Objective To explore the correlation between serum uric acid(SUA) level and Alzheimer's disease(AD) in elderly patients. Methods 67 cases of the elders with Alzheimer's disease and 160 elders matching with age and gender were enrolled from Jan 2013 to Dec 2014 in the study,the blood levels of biochemical factors such as SUA,total cholesterol(TC),triglycerides(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),fasting blood sugar(FBS) and creatinine(Cr) were measured by automatic biochemistry analyzer in the two groups. The related factors such as history of disease,smoking and medication history were collected. The correlation between the level of SUA and AD was analyzed. Results The serum uric acid levels in AD group were significantly lower than those in control group(P＜0.01). Multivariate logistic regression analysis showed that age, gender, ischemic stroke were risk factors, and taking statin, SUA, and HDL-C were protective factors(P＜0.05). Spearman correlation tests indicated that there was an inverse correlation between SUA levels and AD(rs=-0.285,P<0.001). Conclusion Serum uric acid level is significantly related to AD in the elderly.SUA may be a protective factor of the occurrence of AD.