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혈중 요산 수치의 임상적 의의

Clinical Implication of Plasma Uric Acid Level

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주제분류가정의학

초록

혈중 요산 수치의 해석에 대한 논란이 뜨겁다. 해를 거듭할수 록 건강에 대한 관심이 늘어나면서 건강검진 수진율이 급격 히 증가하고 있고, 대부분의 검진기관에서 혈중 요산 수치를 일률적으로 측정하고 있으나 그 결과에 대해 적절하게 해석 하고 설명하는 것은 결코 쉬운 일이 아니다. 최근 10년 동안 요 산의 임상적 의의에 대한 수많은 연구가 발표되었지만, 아직 까지는 이에 대한 명쾌한 해답을 제시하지 못하고 있다. 그러 나 연구대상자의 심혈관 위험도에 따라 그 결과가 제시하는 의미가 다르고, 몇 가지 고식적인 심혈관 위험인자와의 관계 규명에서는 지금까지의 증거만으로도 실제 임상에 적용할 수 있는 실마리를 제공하고 있다. 또한, 혈중 요산 수치를 낮추는 약제의 일률적 사용은 현재로써는 지양되어야 하겠으나, 특 정 고 위험군에서는 그 사용이 어느 정도의 명분을 가질 수 있 을 것이다. 이에 본고에서는 요산의 대사와 그것의 작용을 살 펴보고, 현재까지 진행된 요산관련 연구들을 약간은 다른 관 점에서 고찰함으로써, 향후 검진결과의 해석이나 임상에서의 환자진료에 도움이 되고자 한다.

Abstract

The debate over the clinical meaning of plasma uric acid level is still a very hot issue. As the interest in health grows larger in the general public, the number of having a regular health check-up is increasing rapidly. Most of the health care centers routinely check the plasma uric acid level but it is not simple to interpret and explain the appropriate meaning of that. Over the past decade, there have been several studies on clinical implication of plasma uric acid level but the question still remains. However the clinical signifi cance of the results might be different according to the severity of cardiovascular risk among subjects studied, and the fi ndings for correlation with the established risks have enough proof to be applied to clinical practice. Additionally, the uric acid-lowering agents should not be used in general population even though it has reason to be prescribed in a specifi c high risk patient. Thus, this review seeks to be helpful in clinical practice by examining the preexisting related studies in a different perspective.

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