芜湖地区痛风急性发作诱因及临床生化特征初探

目的 探讨痛风性关节炎急性发作的诱因并对其临床特征进行总结。方法 对2017年11月~2018年12月就诊于皖南医学院第二附属医院内分泌科门诊及住院痛风性关节炎急性发作患者进行问卷调查并收集临床资料，将以上资料录入Excel数据库，对其急性发作诱因及临床特征进行分析。结果 50~60岁为发病年龄高峰，女性患者均为绝经后发病；88.03%的痛风患者急性发作前有诱因，高嘌呤饮食诱发的为61例（52.14%），因饮酒诱发的为55例（47.01%），上述两者中至少含有一项者为81例（69.23%），同时含有两项者为32例（27.35%）；60例患者首发关节部位为足第一跖趾关节，下肢关节受累数目多于上肢关节（113例vs 14例）。发病年龄小的患者比发病年龄大的患者痛风发作频率高；病程长，有痛风石的患者易痛风发作频率高（P均＜0.05）；血尿酸水平高低与患者发作频率无关，两组其他临床生化检查比较，差异无统计学意义（P＞0.05）；年龄、BMI、血尿素氮是痛风石形成的危险因素，频发与长病程同样是痛风石形成的危险因素，差异均有统计学意义（P＜0.05）；Pearson直线相关分析发现:痛风急性发作时血尿酸水平与血尿素氮、血肌酐、胱抑素C相关（P＜0.05）；多因素Logistic分析显示年龄、频发和长病程是痛风石形成的独立危险因素（P＜0.05）。结论 痛风患者中老年居多，发病存在明显性别差异。痛风性关节炎急性发作诱因中以高嘌呤饮食和饮酒为其最常见诱因；发病年龄小，病程长，有痛风石的患者发作频率高。部分痛风性关节炎急性发作时血尿酸水平并不高。年龄偏大、频发和长病程的患者容易形成痛风石。

Preliminary Study on the Causes and Clinical Biochemical Characteristics of Acute Gout in Wuhu Area

Objective To investigate the causes of acute exacerbation of gouty arthritis and to summarize its clinical features.Methods From November 2017 to December 2018, we visited the Department of Endocrinology and the hospitalized patients with acute gouty arthritis in the Second Affiliated Hospital of Wannan Medical College for a questionnaire survey and collected clinical data. The above data were entered into the Excel database for acute Analysis of seizure causes and clinical features.Results The age of onset was 50-60 years old, and the female patients were postmenopausal; 88.03% of gout patients had incentives before acute attack, 61 cases (52.14%) induced by sorghum diet, and 55 cases induced by drinking (47.01%), 81 patients (69.23%) included at least one of them, and 32 patients (27.35%) with two patients. The first joint of 60 patients was the first metatarsophalangeal joint and the lower extremity joint. The number of affected more than the upper limb joints (113 cases vs 14 cases). Patients with younger age of onset had higher frequency of gout attacks than patients with older age; the course of disease was longer, and patients with tophi were prone to have frequent episodes of gout (P<0.05). The level of serum uric acid was not related to the frequency of seizures,there was no significant difference in biochemical examination (P>0.05). Age, BMI and blood urea nitrogen were risk factors for the formation of tophi. Frequent and long-term courses were also risk factors for tophi formation,the differences were statistically significant(P<0.05); Pearson's linear correlation analysis found that blood uric acid level was associated with blood urea nitrogen, serum creatinine and cystatin C during acute gout (P<0.05); multivariate logistic analysis showed age, frequent and long course It was an independent risk factor for the formation of tophi (P<0.05).Conclusion Gout patients are mostly middle-aged and elderly, and there are significant gender differences in the incidence. The cause of acute attack of gouty arthritis is sorghum diet and drinking is the most common cause; the age of onset is small, the course of disease is long, and the frequency of episodes is high. Blood uric acid levels are not high in some episodes of gouty arthritis. Patients with older, frequent, and long-term illnesses are more likely to develop tophi.