《2010年中国痛风临床诊治指南》解读

《2010年中国痛风临床诊治指南》指出,在诊断痛风时要特别注意痛风患者的病程阶段:即无症状高尿酸血症、急性痛风性关节炎或慢性痛风,强调关注患者是否为无症状高尿酸血症或痛风合并其它情况(糖尿病、高血压病,或心脑血管的危险因素)。除了合理应用非甾类抗炎药或糖皮质激素积极治疗急性关节炎急性发作外,痛风患者的综合管理尤为重要,包括对所有患者去除引起高尿酸血症的诱因及给予非药物干预(生活方式和饮食调整、减轻体重、适度饮酒,停用引起尿酸升高的药物等),有效控制合并症。对反复发作的、间歇期或慢性痛风患者给予降尿酸药物治疗以维持血尿酸水平低于327μmol/L,以及为严重的慢性痛风石患者寻找可能的手术治疗机会。

Interpretation of the Chinese guideline for the management of gout in 2010

The Chinese guideline for the management of gout,2010 emphasizes attention towards the stages of gout when making the diagnosis in patients: asymptomatic hyperuricemia,acute gouty arthritis or chronic gout,as well as co morbidities including diabetes mellitus,hypertension and other risk factors for cardiovascular diseases).In addition to reasonable use of nonsteroid anti-inflammatory drugs or corticosteroids during acute gout attack,the integrated management of patients with gout is very important,which includes removal of factors that may cause hyperuricemia and lifestyle therapeutical modifica-tion(eg.weight control,diet,constrain of alcohol,withdrawal of suspicious drugs if possible,etc.),and effective control of the comorbidities.The serum urate levels should be maintained below 327μmol/L by uric acid lowering therapies for recur-rent,intercritical gout and chronic gout.Surgical treatment may be a reasonable alternative for patients with serious tophi.