尿酸与女性生殖系统疾病及妊娠结局的相关性

doi:10.12280/gjszjk.20230415

摘要/Abstract

摘要：

尿酸（uric acid）是内、外源性嘌呤代谢的最终产物，在正常情况下，人体内尿酸的合成和排泄处于动态平衡状态。研究显示，血尿酸水平与女性生殖系统疾病、妊娠结局紧密相关。多囊卵巢综合征（polycystic ovary syndrome，PCOS）女性发生高尿酸血症的风险高于非PCOS女性，在通过辅助生殖技术助孕的PCOS患者中，血尿酸水平升高与临床妊娠率和活产率的降低及低出生体质量儿风险增加独立相关。白细胞介素-1β可能是血尿酸和子宫内膜异位症之间的连接桥梁，引起子宫内膜蜕膜化功能失调，从而导致不孕。同时孕妇血尿酸水平升高可引起妊娠期高血压、子痫前期和妊娠期糖尿病等妊娠并发症，导致子代早产、低出生体质量等不良妊娠结局。综述尿酸对育龄期女性的生殖健康和妊娠结局的影响，为临床制定诊疗策略提供有意义的参考。

关键词: 高尿酸血症, 不育, 妊娠结局, 多囊卵巢综合征, 子宫内膜异位症

Abstract:

Uric acid is the end product of endogenous and exogenous purine metabolism. Under normal conditions, the synthesis and excretion of uric acid in the body are in a state of dynamic balance. Studies have shown that the level of serum uric acid is strongly associated with female reproductive disorders and pregnancy outcomes. The patients with polycystic ovary syndrome (PCOS) have a higher risk of hyperuricemia than those women of non-PCOS. In women with PCOS undergoing IVF or ICSI, the elevated level of serum uric acid is associated with the decreased rates of clinical pregnancy and live birth, and with the increased risk of low birthweight. Interleukin-1β is a possible connecting bridge between serum uric acid and endometriosis, causing the dysfunction of endometrial metaplasia and infertility. Furthermore, the elevated uric acid in pregnant women can cause gestational hypertension, pre-eclampsia and gestational diabetes mellitus, which can lead to adverse pregnancy outcomes such as premature delivery and low birth weight of offspring. In this article, we review the relationship between uric acid and female reproductive disorders and pregnancy outcomes, to provide a reference for clinical diagnosis and treatment strategies.

Key words: Hyperuricacidemia, Infertility, Pregnancy outcome, Polycystic ovary syndrome, Endometriosis

王洁, 马翔. 尿酸与女性生殖系统疾病及妊娠结局的相关性[J]. 国际生殖健康/计划生育杂志, 2024, 43(1): 63-67.

WANG Jie, MA Xiang. Relationship between Uric Acid and Female Reproductive Disorders and Pregnancy Outcomes[J]. Journal of International Reproductive Health/Family Planning, 2024, 43(1): 63-67.

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