1例心力衰竭伴痛风发作患者的药物分析及文献回顾

摘 要 目的：探索心力衰竭伴利尿药诱发痛风性关节炎患者的合理用药原则。方法: 临床药师通过参与1例心力衰竭应用呋塞米诱发痛风性关节炎患者的诊疗和药物分析调整，充分考虑到患者疾病症状及可能诱导痛风发作的药物，建议停用相关药物，并调整治疗药物。结果: 临床药师考虑该患者自身特点，调整了合理治疗方案，医师采纳建议后，患者痛风症状缓解，心力衰竭得到控制，病情改善。结论:心力衰竭合并痛风史的患者应用利尿药，极易诱发痛风，建议小剂量使用对血尿酸水平影响相对较少的利尿药。临床药师通过参与临床治疗，发挥药师的专业优势，优化用药方案，可降低患者发生不良反应风险，促进患者安全合理用药。

Drug Analysis and Literature Review of One Patient with Heart Failure and Gouty Attack

ABSTRACT Objective: To investigate the principles of rational drug use for the patients suffering from heart failure complicated with diuretic induced gouty arthritis. Methods: The clinical pharmacist participated in the diagnosis, treatment and drug adjustment of one patient suffering from heart failure complicated with furosemide induced gouty arthritis. Taking the disease symptoms and potential gouty inducing drugs into full consideration, clinical pharmacist suggested the withdrawal of related drugs and the adjustment of treatment plan. Results:Considering the characteristics of the patient, clinical pharmacist adjusted the rational drug treatment. After the adoption of the suggestions, the gouty symptoms were relieved, heart failure was controlled and the condition was improved. Conclusion:Loop diuretics can easily trigger an acute attack of gout, especially for the patients with heart failure and gout history. Clinical pharmacist can make full use of professional advantages to optimize the treatment plan in order to reduce adverse reactions and promote the rational drug use by participating in clinical practice.