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草稿:VideoWiki:Gout

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定义

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痛风是一种发炎性关节炎英语inflammatory arthritis特征是单一关节反复关节炎发作,出现红、英语joint effusion、热和疼痛的症状[1][2]

症状 1

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疼痛症状通常很快发作,在十二小时内达到最痛[3]。有一半患者,疼痛发生在大脚趾底部的关节英语Metatarsophalangeal articulations[4]

症状 2

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它可能造成痛风石肾结石尿酸肾病英语urate nephropathy[3]

病因 1

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痛风是由血中尿酸持续过高造成[3][2]

病因 2

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这是由饮食、其他健康问题遗传等因素综合作用而成[3][2]。在血中尿酸浓度持续偏高的影响下,尿酸结晶沉积在关节、肌腱周围组织中,之后引起痛风发作[3]

病因 3

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经常食用肉类、海鲜、喝啤酒或体重过重的人更容易合并痛风[3][5]

诊断

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关节液关节外的组织中发现尿酸结晶即可确诊[3]。血中尿酸浓度在发作期间可能正常[3]


治疗

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使用秋水仙素非类固醇抗发炎药(NSAIDs)或类固醇皆可改善症状[3][2][6]

预防

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在急性发作缓解后,可以透过调整生活方式或使用别嘌醇等药物降低血中尿酸浓度[3]。 补充维生素C和食用低脂乳制品可能可以预防痛风[7]

流行病学 1

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欧美,一生中会发生痛风的人口约占 1% 至 2% [3]。近几十年来,痛风的发病率有所增加[3]

流行病学 2

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痛风最好发在老年男性[3]

历史

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历史上,痛风被称为“帝王病”或“富贵病”[3][8],且自古埃及时即此[3]

References

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  1. ^ Chen LX, Schumacher HR. Gout: an evidence-based review. J Clin Rheumatol. October 2008, 14 (5 Suppl): S55–62. PMID 18830092. doi:10.1097/RHU.0b013e3181896921. 
  2. ^ 2.0 2.1 2.2 2.3 Hui, M; Carr, A; Cameron, S; Davenport, G; Doherty, M; Forrester, H; Jenkins, W; Jordan, KM; Mallen, CD; McDonald, TM; Nuki, G; Pywell, A; Zhang, W; Roddy, E; British Society for Rheumatology Standards, Audit and Guidelines Working, Group. The British Society for Rheumatology Guideline for the Management of Gout. Rheumatology (Oxford, England). 26 May 2017, 56 (7): e1–e20. PMID 28549177. doi:10.1093/rheumatology/kex156. 
  3. ^ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 Richette P, Bardin T. Gout. Lancet. January 2010, 375 (9711): 318–28. PMID 19692116. doi:10.1016/S0140-6736(09)60883-7. 
  4. ^ Schlesinger N. Diagnosing and treating gout: a review to aid primary care physicians. Postgrad Med. March 2010, 122 (2): 157–61. PMID 20203467. doi:10.3810/pgm.2010.03.2133. 
  5. ^ Beyl Jr, R. N.; Hughes, L; Morgan, S. Update on Importance of Diet in Gout. The American Journal of Medicine. 2016, 129 (11): 1153–1158. PMID 27452679. doi:10.1016/j.amjmed.2016.06.040. 
  6. ^ Shekelle, P. G; Newberry, S. J; Fitzgerald, J. D; Motala, A; O'Hanlon, C. E; Tariq, A; Okunogbe, A; Han, D; Shanman, R. Management of Gout: A Systematic Review in Support of an American College of Physicians Clinical Practice Guideline. Annals of Internal Medicine. 2017, 166 (1): 37–51. PMID 27802478. doi:10.7326/M16-0461. 
  7. ^ Questions and Answers about Gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases. June 2015 [2 February 2016]. (原始内容存档于15 January 2016). 
  8. ^ Rich Man's Disease – definition of Rich Man's Disease in the Medical dictionary. Free Online Medical Dictionary, Thesaurus and Encyclopedia.