方小琳,罗 跃,武小娟

随着现代社会生活节奏加快，选择高嘌呤、高盐高脂的食物且长期缺乏运动的人群基数也在不断扩大。尿酸（UA）是人体内嘌呤代谢的终产物，嘌呤代谢障碍可导致高尿酸血症（HUA）的发生。目前已有大量研究证实HUA是高血压（HTN）的独立危险因素，两者密切相关，往往合并出现，增加罹患心血管疾病风险。然而有研究报道，肠道菌群既参与促进嘌呤和尿酸的分解以及减少吸收，还参与血压的调节。故本文将总结有关肠道菌群调节尿酸代谢的机制以及其对血清尿酸水平和血压波动影响的研究，以期为临床治疗方案的选择提供参考。

肠道菌群；高尿酸血症；高血压；尿酸代谢；机制

[1] 中国高尿酸血症相关疾病诊疗多学科专家共识(2023年版). [2] 中国高血压防治指南修订委员会.中国高血压防治指南(2018年修订版). [3] Euser SM,Hofman A,Westendorp RG,Breteler MM.Serum uric acid and cognitive function and dementia.Brain 2009;132:377–382. [4] 刘靖.重视高血压患者高尿酸血症的筛查与管理[J].中华高血压杂志,2021,29(08):701-702. [5] 张洪金,胡铭,赖泽群,等.血尿酸水平与血压昼夜节律异常的相关性研究进展[J].中华高血压杂志,2023,31(03):222-226. [6] 隋小芳,沈士琨,王凤玲,等.原发性高血压合并高尿酸血症的危险因素分析[J].中国实验诊断学,2021,25(04):514-516. [7] 中国食品科学技术学会益生菌分会.人体肠道菌群主要特征的专家共识[J].中国食品学报,2024,24(07):460-470. [8] Schoeler,Marc.,and Caesar,Robert.."Dietary lipids,gut microbiota and lipid metabolism."Reviews in endocrine&metabolic disorders 20.4(2019):461-472. [9] Tanes,Ceylan.,Bittinger,Kyle.,Gao,Yuan.,Friedman,Elliot S.,and Nessel,Lisa.."Role of dietary fiber in the recovery of the human gut microbiome and its metabolome."Cell hostµbe 29.3(2021):394-407.e5. [10] Lu,YY,Zeng,Y,Hu,GY,et al.High-throughput sequencing for analysis of structural change of intestinal microbiota in patients with colorectal adenoma.Nan Fang Yi Ke Da Xue Xue Bao.2017;37(9):1156-1163.PMID:28951355. [11] 古文鹏,吕迪,周晓芳,等.感染性腹泻患者肠道菌群失衡特征分析[J].中国人兽共患病学报,2024,40(05):408-414. [12] Zhang,M,Sasaki,H,Yang,T,et al.Fecal microbiota transplantation from Suncus murinus,an obesity-resistant animal,to C57BL/6NCrSIc mice,and the antibiotic effects in the approach.Front Microbiol.2023;14 1138983. [13] Kolz M,Johnson T,Sanna S,Teumer A,Vitart V,et al.Meta-analysis of 28,141 individuals identifies common variants within five new loci that influence uric acid concentrations.PLoS Genet.2009;5:1–10. [14] 王雨,林志健,张冰.高尿酸血症大鼠的肠道尿酸排泄研究[J].北京中医药大学学报,2018,41(2):110-11. [15] García-Arroyo FE,Gonzaga G,Muñoz-Jiménez I,et al.Probiotic sup-plements prevented oxonic acid-induced hyperuricemia and renal dam-age[J].PLoS One,2018,13(8):e0202901. [16] Ni C,Li X,Wang L,Li X,Zhao J,Zhang H,Wang G,Chen W.Lactic acid bacteria strains relieve hyperuricaemia by suppressing xanthine oxidase activity via a short-chain fatty acid-dependent mechanism.Food Funct.2021 Aug 2;12(15):7054-7067. [17] 尧贵林,王海勇,陆涛.促尿酸排泄药物研究进展[J].中国药科大学学报,2016,47(04):491-496. [18] Góth L.Az uratoxidaz-(rasburicas-)terápia lehetséges szövôdménye a hidrogen-peroxid okozta sokk[Rasburicase therapy may cause hydrogen peroxide shock].Orv Hetil.2008 Aug 24;149(34):1587-90.Hungarian. [19] 于婷婷,程翅,喻田.尿酸肠道代谢的研究现状[J].中国临床药理学杂志,2021,37(21):2978-2980;2984. [20] Yang,Tao et al.“Gut dysbiosis is linked to hypertension.”Hypertension(Dallas,Tex.:1979)vol.65,6(2015):1331-40. [21] Bier A,Braun T,Khasbab R,et al.A high salt diet modulates the gut microbiota and short chain fatty acids production in a salt‐sensitive hypertension rat model.Nutrients.2018;10:E1154 10.3390/nu10091154. [22] Naqvi S,Asar TO,Kumar V,Al-Abbasi FA,Alhayyani S,Kamal MA,Anwar F.A cross-talk between gut microbiome,salt and hypertension.Biomed Pharmacother.2021 Feb;134:111156. [23] Smits,LP,Kootte,RS,Levin,E,et al.Effect of Vegan Fecal Microbiota Transplantation on Carnitine and Choline-Derived Trimethylamine-N-Oxide Production and Vascular Inflammation in Patients With Metabolic Syndrome.J Am Heart Assoc.2018;7(7). [24] LOZUPONE C A,STOMBAUGH J I,GORDON J I,et al..Diversity,stability and resilience of the human gut microbiota[J]. Nature, 2012,489(7415):220-230.

点击下载PDF