质子泵抑制剂治疗上消化道出血对痛风复发的影响

目的 通过观察上消化道出血的痛风患者使用质子泵抑制剂（PPI）治疗前后临床症状及尿酸的变化，以探讨PPI治疗上消化道出血对痛风复发的影响。方法 选择我院上消化道出血合并原发性痛风患者37例为痛风组，同期37例上消化道出血且无痛风患者为对照组。两组患者在使用PPI前后分别监测尿酸、体温、关节肿痛等指标，并对相关指标进行统计学分析。结果 痛风组使用PPI后血尿酸较用药前升高（49.24±111.49）μmol/L，差异有统计学意义（P＜0.05）；对照组PPI使用后血尿酸较用药前升高（2.89±47.87）μmol/L，但差异无统计学意义（P＞0.05）。痛风组用药前后尿酸变化差值大于对照组，差异有统计学意义（P＜0.05）。使用PPI治疗后，痛风组64.86%出现非感染性发热，75.68%出现新发关节疼痛，患者疼痛评分较用药前增加（P＜0.001），而对照组患者未出现关节痛及发热病例。结论 上消化道出血的痛风患者使用PPI可能诱发或加重痛风疾病的活动。

Effect of Proton Pump Inhibitor on Upper Gastrointestinal Hemorrhage on Recurrence of Gout

Objective To investigate the effects of PPI on upper gastrointestinal bleeding and gout recurrence by observing the changes of clinical symptoms and uric acid before and after treatment with proton pump inhibitor (PPI) in gout patients with upper gastrointestinal bleeding. Methods 37 patients with upper gastrointestinal hemorrhage complicated with primary gout were selected as gout group. 37 patients with upper gastrointestinal hemorrhage and no gout were the control group. The two groups of patients were monitored for uric acid, body temperature, joint swelling and pain before and after the use of PPI, and the relevant indicators were statistically analyzed. Results After the use of PPI in the gout group, the blood uric acid increased (49.24±111.49) μmol/L, the difference was statistically significant (P<0.05). The blood uric acid increased after the use of PPI in the control group (2.89±47.87)μmol/L, but the difference was not statistically significant (P>0.05). The difference of uric acid changes before and after treatment in the gout group was greater than that in the control group,the difference was statistically significant (P<0.05). After treatment with PPI, 64.86% of the gout group had non-infectious fever, 75.68% had new-onset joint pain, and the patient's pain score increased before the medication (P<0.001), while the control group did not have joint pain and fever. Conclusion The use of PPI in gout patients with upper gastrointestinal bleeding may induce or aggravate gout disease activity.