无症状高尿酸血症对肩袖修补术后疗效影响的分析

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Abstract Objective To preliminarily study the effect of asymptomatic hyperuricemia on functional recovery of the shoulder joint and tendon healing in patients after arthroscopic rotator cuff repair. Methods We retrospectively analyzed the clinical data of 55 patients with rotator cuff tears admitted to the Orthopedic Center of Xinjiang Uygur People’s Hospital between November 2021 and January 2023.The study participants were divided into two groups based on their blood uric acid levels：The hyperuricemia group (26 cases) and the normal blood uric acid group (29 cases).Hyperuricemia was diagnosed when the uric acid level was greater than 420 μmol/L on two separate occasions (not on the same day).The hyperuricemia group consisted of 17 males and 9 females，with ages ranging from 38 to 69 years old and an average age of (53.4±8.8) years old.The normal blood uric acid group consisted of 16 males and 13 females，with ages ranging from 44 to 74 years old and an average age of (53.9±11.3) years old.Shoulder flexion mobility，external rotation mobility，internal rotation mobility，visual analogue scale (VAS)，Constant-Murley shoulder score，American shoulder and elbow surgeon(ASES) were recorded at 3 months and 6 months after surgery.At the final follow-up，shoulder radiographs and MRI were conducted to evaluate the healing of the rotator cuff using the Sugaya evaluation criteria. Results 55 patients were followed up postoperatively，ranging from 6 to 8 months，the follow-up times in the hyperuricemic and normal groups were (6.56±0.64) months and (6.62±0.62) months，respectively，and the difference in the follow-up times between the two groups did not reach statistical significance ( t ＝－0.256， P ＝ 0.771 ).The postoperative observational indexes of patients in both groups were significantly improved compared with the preoperative period ( P ＜0.05).The follow-up results at 3 and 6 months after surgery showed that the postoperative shoulder forward flexion mobility，external rotation mobility，internal rotation mobility，VAS score，Constant-Murley shoulder score，and ASES score of patients in the normal blood uric acid group were better than those of patients in the hyperuricemia group，and the difference was statistically significant ( P ＜0.05).Shoulder MRI was performed in 43 patients at the last follow-up.According to the Sugaya criteria，the evaluation results showed that MRI grading was better in patients with normal blood uric acid than in the hyperuricemia group，and the difference between the two groups was statistically significant ( Z ＝－1.985， P ＝0.047). Conclusion Among the patients after arthroscopic rotator cuff repair，the shoulder joint function，pain level and tendon healing results of patients with normal blood uric acid are better than those of patients with hyperuricemia.

Key words： hyperuricemia rotator cuff tear gout rotator cuff repair

Corresponding Authors: Zhang Haoshaqiang

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	Tudaji·Wubulihasimu
	Zhang Haoshaqiang
	Wang Zhigang
	Li Kun

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Tudaji·Wubulihasimu,Zhang Haoshaqiang,Wang Zhigang, et al. Analysis of the Impact of Asymptomatic Hyperuricemia on Patient Outcomes After Rotator Cuff Repair[J]. sygkzz, 2024, 30(2): 120-.

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http://www.sygkzz.com/EN/ OR http://www.sygkzz.com/EN/Y2024/V30/I2/120

［1］ Dehlin M，Jacobsson L，Roddy E.Global epidemiology of gout：prevalence，incidence，treatment patterns and risk factors［J］.Nat Rev Rheumatol，2020，16(7)：380-390.
［2］ Ventura-Ríos L，Sánchez-Bringas G，Pineda C， et al .Tendon involvement in patients with gout：An ultrasound study of prevalence［J］.Clin Rheumatol，2016，35(8)：2039-2044.
［3］ Bursill D，Taylor WJ，Terkeltaub R， et al .Gout，hyperuricemia，and crystal-associated disease network consensus statement regarding labels and definitions for disease elements in gout［J］.Arthritis Care Res (Hoboken)，2019，71(3)：427-434.
［4］ Andia I，Abate M.Hyperuricemia in Tendons［J］.Adv Exp Med Biol，2016(920)：123-132.
［5］ Qaseem A，Harris RP，Forciea MA， et al .Management of acute and recurrent gout：A clinical practice guideline from the american college of physicians［J］.Ann Intern Med，2017，166(1)：58-68.
［6］ Gaubert M，Bardin T，Cohen-Solal A， et al .Hyperuricemia and hypertension，coronary artery disease，kidney disease：From concept to practice［J］.Int J Mol Sci，2020，21(11)：4066.
［7］ Hisatome I，Li P，Miake J， et al .Uric acid as a risk factor for chronic kidney disease and cardiovascular disease Japanese guideline on the management of asymptomatic hyperuricemia［J］.Circ J，2021，85(2)：130-138.
［8］秦明照.重视高尿酸血症的管理［J］.中华健康管理学杂志，2023，17(7)：481-484.
［9］ Lafrance S，Charron M，Roy JS， et al .Diagnosing，managing，and supporting return to work of adults with rotator cuff disorders：A clinical practice guideline［J］.J Orthop Sports Phys Ther，2022，52(10)：647-664.
［10］ Jeong HJ，Nam KP，Yeo JH， et al .Retear after arthroscopic rotator cuff repair results in functional outcome deterioration over time［J］.Arthroscopy，2022，38(8)：2399-2412.
［11］ Nichols AEC，Oh I，Loiselle AE.Effects of type Ⅱ diabetes mellitus on tendon homeostasis and healing［J］.J Orthop Res，2020，38(1)：13-22.
［12］ Waugh CM，Mousavizadeh R，Lee J， et al .The impact of mild hypercholesterolemia on injury repair in the rat patellar tendon［J］.J Orthop Res，2023，41(9)：1871-1881.
［13］ Huang SW，Wu CW，Lin LF， et al .Gout can increase the risk of receiving rotator cuff tear repair surgery［J］.Am J Sports Med，2017，45(10)：2355-2363.
［14］韩增帅，赵夏，马温儒，等.无症状高尿酸血症对关节镜肩袖修补术后临床效果影响的初步分析［J］.中国修复重建外科杂志，2021，35(6)：667-672.
［15］ Maiuolo J，Oppedisano F，Gratteri S， et al .Regulation of uric acid metabolism and excretion［J］.Int J Cardiol，2016(213)：8-14.
［16］ Keenan R T.The biology of urate［J］.Semin Arthritis Rheum，2020，50(3S)：S2-s10.
［17］ Zhang M，Zhu X，Wu J， et al .Prevalence of hyperuricemia among chinese adults：Findings from two nationally representative cross-sectional surveys in 2015-16 and 2018-19［J］.Front Immunol，2021(12)：791983.
［18］ Richette P，Doherty M，Pascual E， et al .2018 updated european league against rheumatism evidence-based recommendations for the diagnosis of gout［J］.Ann Rheum Dis，2020，79(1)：31-38.
［19］ Yuan Y，Liu C，Xiang X， et al .Ultrasound scans and dual energy CT identify tendons as preferred anatomical location of MSU crystal depositions in gouty joints［J］.Rheumatol Int，2018，38(5)：801-811.
［20］彭喆，丁亚敏，裴林，等.痛风患者发生关节及肌腱内晶体沉积的临床特点［J］.北京大学学报(医学版)［J］.2021，53(6)：1067-1071.
［21］ Zhao J，Wei K，Jiang P， et al .Inflammatory response to regulated cell death in gout and its functional implications［J］.Front Immunol，2022(13)：888306.
［22］ Sasaki K，Yamamoto N，Kiyosawa T， et al .The role of collagen arrangement change during tendon healing demonstrated by scanning electron microscopy［J］.J Electron Microsc (Tokyo)，2012，61(5)：327-334.
［23］ Chhana A，Callon KE，Dray M， et al .Interactions 〖CM(22〗 between tenocytes and monosodium urate monohydrate crystals：Implications for tendon involvement in gout［J］.Ann Rheum Dis，2014，73(9)：1737-1741.
［24］ Martinon F.Mechanisms of uric acid crystal-mediated autoinflammation［J］.Immunol Rev，2010，233(1)：218-232.
［25］ Shi Y，Mucsi AD，Ng G.Monosodium urate crystals in inflammation and immunity［J］.Immunol Rev，2010，233(1)：203-217.
［26］ Egerbacher M，Gardner K，Caballero O， et al .Stress-deprivation induces an up-regulation of versican and connexin-43 mRNA and protein synthesis and increased ADAMTS-1 production in tendon cells in situ［J］.Connect Tissue Res，2022，63(1)：43-52.
［27］ Dalbeth N，House ME，Aati O， et al .Urate crystal deposition in asymptomatic hyperuricaemia and symptomatic gout：A dual energy CT study［J］.Ann Rheum Dis，2015，74(5)：908-911.
［28］ Abate M，Schiavone C，Salini V， et al .Occurrence of tendon pathologies in metabolic disorders［J］.Rheumatology (Oxford)，2013，52(4)：599-608.
［29］ Chisari E，Rehak L，Khan W S， et al .Tendon healing is adversely affected by low-grade inflammation［J］.J Orthop Surg Res，2021，16(1)：700.
［30］ Tarafder S，Chen E，Jun Y， et al .Tendon stem/progenitor cells regulate inflammation in tendon healing via JNK and STAT3 signaling［J］.Faseb J，2017，31(9)：3991-3998.
［31］ Qin S，Wang W，Liu Z， et al .Fibrochondrogenic differentiation potential of tendon-derived stem/progenitor cells from human patellar tendon［J］.J Orthop Translat，2019(22)：101-108.
［32］ Qin SN，Bennett S，Wen W， et al .The role of tendon derived stem/progenitor cells and extracellular matrix components in the bone tendon junction repair［J］.Bone，2021(153)：116172.
［33］ Wang W，Qin S，He P， et al .Type Ⅱ collagen sponges facilitate tendon stem/progenitor cells to adopt more chondrogenic phenotypes and promote the regeneration of fibrocartilage-like tissues in a rabbit partial patellectomy model［J］.Front Cell Dev Biol，2021(9)：682719.
［34］ Liang J，Chen B，Li Y， et al .Asymptomatic hyperuricemia is associated with achilles tendon rupture through disrupting the normal functions of tendon stem/progenitor cells［J］.Stem Cells Int，2022(2022)：6795573.