Ukugcwala kwe-uric acid kunganqunywa egazini noma kumchamo. Ngokweqile, ngokuvamile kuwuphawu lwe-gout, ukuphuza kakhulu utshwala noma ukwehluleka kwezinso.

I-Uric acid iyi-a imfucuza komzimba. Ngokuqondile, kungumkhiqizo wokugcina we-excretion ama-molecule abizwa ngokuthi ama-nucleic acid nama-purines.

Imvamisa, iningi le-uric acid emzimbeni womuntu liyancibilika egazini bese lingena ezinso ukuze likhishwe emchamweni. Kodwa kwezinye izimo, umzimba ukhiqiza i-uric acid eyeqile noma wehluleke ukuyikhipha eyanele. Lesi simo singaba imbangela yezinkinga ezihlukahlukene.

I-Uric acid ingumkhiqizo wokugcina wokuwohloka kwe ukubabaza, izinga layo liyahlukahluka kuye ngokuthi okuqukethwe kwe-purine emzimbeni. Futhi kuvela ukuthi ama-purines atholakala ikakhulukazi ekudleni. 

Okunye ukudla okune-purines ephezulu okufanele ukugweme yizi:

• ama-anchovies, ama-herring, ama-mackerel, ama-sardine, ama-shrimps, njll;
• isibindi, inhliziyo, ubuchopho, izinso, izinkwa ezinoshukela, njll;
• uphizi, ubhontshisi owomile, njll.

Ukusetshenziswa kotshwala, ikakhulukazi ubhiya, akunconywa uma ufuna ukunciphisa i-uric acid yakho.

Ngokuphambene nalokho, phakathi kokudla okuvunyelwe okuphansi kwe-purine, singabala:

• itiye, ikhofi, iziphuzo ezibandayo;
• izithelo nemifino;
• amaqanda;
• isinkwa namabele;
• ushizi kanye nemikhiqizo yobisi ngokuvamile

Kungani kuhlolwa i-uric acid?

Udokotela unquma ukuhlolwa kwegazi (okuthiwa i-uricemia) kanye / noma ukuhlolwa kwe-uric acid yomchamo:

• thola i-gout;
• hlola ukuthi izinso zisebenza kahle kangakanani;
• kungabuye kucelwe uma kwenzeka ukhulelwe;
• noma kubantu abakhuluphele ngokweqile.

Qaphela ukuthi ukuhlaziya ukugcwala kwe-uric acid emchameni kuzokwenza kube nokwenzeka ukuqonda kangcono umsuka wezinga eliphezulu le-uric acid egazini.

Egazini, inani elijwayelekile le-uric acid liphakathi kuka-35 no-70 mg / L.

Ukugcwala okuphezulu kwe-uric acid egazini kubizwa i-hyperuricemia futhi kungadalwa ukukhiqizwa ngokweqile kwe-uric acid emzimbeni noma ukuncipha kokukhishwa kwayo yizinso. Ngakho, amazinga aphezulu e-uric acid egazini angaba uphawu lwalokhu:

• i-gout (lokhu kuyimbangela eyinhloko yokwanda kwezinga le-uric acid egazini);
• ukweqisa kokuwohloka kwamaprotheni omzimba okwenzeka, isibonelo, ngesikhathi se-chemotherapy, i-leukemia noma i-lymphoma;
• ukuphuza ngokweqile;
• ukuvivinya umzimba ngokweqile;
• ukuba khona kwamatshe ezinso;
• ukulahlekelwa isisindo ngokushesha;
• isifo sikashukela;
• ukudla okucebile nge-purine;
• i-preeclampsia ngesikhathi sokukhulelwa;
• noma ukwehluleka kwezinso.

Ngokuphambene nalokho, kungenzeka ukuthi izinga le-uric acid egazini liphansi kunokuvamile, kodwa lesi yisimo esingavamile kunesimo lapho sigcina sesiphezulu.

Ngakho-ke, amazinga e-uric acid angaphansi kwamanani ajwayelekile angahlotshaniswa nalokhu:

• ukudla okuphansi kwe-purine;
• Isifo sikaWilson (isifo sofuzo lapho ithusi lakheka khona emzimbeni);
• izinso (njenge-Fanconi syndrome) noma ukulimala kwesibindi;
• noma ngisho nokuchayeka kuzinhlanganisela ezinobuthi (umthofu).

Emchameni, inani elijwayelekile le-uric acid liphakathi kuka-250 no-750 mg / amahora angu-24.

Qaphela ukuthi amanani ajwayelekile angahluka kancane ngokuya ngamalabhorethri enza lokho kuhlaziywa.

Okuthinta u-5 kuya ku-15% wabantu, kuwukungajwayelekile okujwayelekile kwamakhemikhali e-biochemical, okubangelwa ukukhiqizwa ngokweqile kwe-uric acid kanye / noma ukunciphisa ukuqedwa kwezinso. Ivamise ukukhula ngaphandle kobuhlungu ngakho-ke ayitholakali ngaso sonke isikhathi ngokushesha.

Amazinga aphezulu e-uric acid angachazwa ngokuthi:

Idiopathic noma i-hyperuricemia eyinhloko

Bamele iningi lamacala. I-Hereditary predispositions itholakala ku-30% yezifundo, kodwa ngokuvamile ihlotshaniswa nokukhuluphala, ukudla ngokweqile, umfutho wegazi ophakeme, ukusebenzisa kabi utshwala, isifo sikashukela kanye ne-hypertriglyceridemia.

Ukungajwayelekile kwe-enzyme

Zitholakala ikakhulukazi ku-Von Gierke isifo kanye nesifo se-Lesch-Nyhan. Lezi zinto ezingavamile ze-enzymatic zinezici zokubangela ukuhlaselwa yi-gout kusenesikhathi, okungukuthi eminyakeni yokuqala engama-20 yokuphila.

I-Hyperuricemia yesibili yesifo noma ukwelashwa kwezidakamizwa.

Lokhu kungenxa ye-hyperuricemia:

- ukuntuleka kokuqedwa kwe-uric acid. Lokhu kuyinkinga yokwehluleka kwezinso, kodwa futhi ngenxa yezidakamizwa ezithile (ama-diuretics, kodwa futhi ama-laxatives kanye nezidakamizwa ezithile ezilwa nesifo sofuba).

- ukwanda kokuwohloka kwama-nucleic acid. Lokhu sikubona ezifweni zegazi (i-leukemia, i-hemopathies, i-hemolytic anemia, i-psoriasis ebanzi), kanye nemiphumela ye-chemotherapies ethile yomdlavuza.

Imiphumela ye-hyperuricemia

I-Hyperuricemia ingabangela izinhlobo ezimbili zezinkinga:

• I-Gout ebhekene nobuhlungu bohlobo lokuvuvukala.

Uma ama-microcrystals e-uric acid encibilikisiwe egazini eseqoqweni eliphezulu kakhulu futhi izimo zasendaweni zivuma (ikakhulukazi i-asidi eyanele yendawo emaphakathi), aginqa futhi aholele ekuvuvukeni kwendawo. Lokhu kuthinta kakhulu ilunga lozwane olukhulu. Umuntu oyedwa kwabayi-1 kuphela one-uric acid eningi egazini ozothola i-gout, ngakho udinga ukuthambekela okwengeziwe ukuze uyithole.

• I-lithiasis yomchamo.

Zibangelwa ukuba khona kwetshe elilodwa noma ngaphezulu emgudwini womchamo futhi banesibopho se-renal colic. I-Urolithiasis yisifo esivame kakhulu kusukela ku-1 kuya ku-2% wabantu abathintekayo eFrance.

Ukuhlaziywa kwezinga le-asidi eyodwa kungenziwa egazini kanye / noma kumchamo:

• ukuhlolwa kwegazi kuhlanganisa isampula yegazi le-venous, ngokuvamile ekuqhekezeni kwendololwane;
• izinga le-uric acid emcinini likalwa ngaphezu kwamahora angu-24: ukwenza lokhu, kwanele ukuchama esitsheni esihlinzekwe ngale njongo futhi sinikezwe abasebenzi bezokwelapha usuku olulodwa nobusuku obubodwa.

Qaphela ukuthi kuyatuseka ukuthi ungadli noma uphuze noma yini phakathi namahora andulela ukuhlolwa.

Ziningi izinto ezingathinta izinga le-uric acid egazini noma emchamweni. Lokhu kubandakanya:

• ukudla (okubi noma okuphezulu kuma-purines);
• izidakamizwa (ukusayina i-gout, i-aspirin, noma i-diuretics);
• ubudala, izingane ezinezindinganiso eziphansi;
• ubulili, lapho abesifazane ngokuvamile benezilinganiso eziphansi kunabesilisa;
• isisindo, abantu abakhuluphele abanezinga eliphezulu.

Ukwelashwa kwezidakamizwa uma i-hyperuremia inezimpawu ezilandelayo: 

• Izinciphisi ze-Nucleic acid synthesis, njenge-allopurinol. Kufanele uqaphe kakhulu ngoba kuningi ukusebenzisana nezinye izidakamizwa.
• Imithi evimbela ukumuncwa kabusha kwe-uric acid yezinso, njenge-benzbromarone.
• Ukwelashwa nge-Enzymatic okuvame ukudala izinkinga zokungezwani komzimba nezinto ezithile.

Kungakhathaliseki ukuthi kwenzekani, ngudokotela okufanele anqume ukuthi ukwelashwa kufanele kulandelwe yini, futhi yikuphi okufaneleka kakhulu.