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难治性痛风30例临床治疗

来源期刊: 广州医药 | 89-93 发布时间:2021-12-21 收稿时间:2025/11/13 17:38:26 阅读量:12
作者:
关键词:
关节炎痛风肌骨超声预后难治性
DOI:
10.3969/j.issn.1000-8535.2019.01.023
收稿时间:
2018-07-17 
修订日期:
 
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引用总数:
0  
目的 分析难治性痛风的治疗效果及经验总结。方法 收集30例难治性痛风性关节炎患者分长病程及短病程组,对比各组基线指标及治疗后的血尿酸水平,肾功能情况及受累部位关节超声变化,及患者VAS评分比较,最后统计分析组间差异及探讨难治性痛风预后与降尿酸控制水平、炎症指标、血肌酐变化的相关性。结果 30例痛风患者治疗前后对比,短病程组患者VAS评分从5.6±3.3下降至3.2±1.1,血沉从59.3±12.4下降至20.6±6.9,受累关节滑膜厚度从(3.57±0.63)mm下降至(1.96±0.65)mm,血尿酸从(589.3±146.2)μmol/L下降至(403.8±96.4)μmol/L,P<0.05;短病程组及并发症少的患者改善更明显,血尿酸控制更低的患者相关指标下降更明显,P<0.01;患者的血尿酸下降趋势跟关节滑膜厚度与炎症指标(ESR)、血肌酐的变化趋势符合,通过回归分析有相关性意义,P<0.05。结论 难治性痛风的处理核心还是有效的控制尿酸,但需要对影响预后的因素,包括感染、肾功能不全、消化性溃疡等并发症进行风险管理,降低相关风险及合并症治疗对难治性痛风的有效治疗管理非常重要。
1、 JOHANNSDOTTIR GA,PALSSON O,JONSSON H,et al.Gout - a treatable condition[J]. Laeknabladid,2018 ,104(4):177-186. JOHANNSDOTTIR GA,PALSSON O,JONSSON H,et al.Gout - a treatable condition[J]. Laeknabladid,2018 ,104(4):177-186.
2、 FISHER M C,RAI S K,LU N,et al.Response to:Is optimizing gout treatment the key to closing the mortality gap in gout patient?[J]. Ann Rheum Dis,2017,77(1): e2 . FISHER M C,RAI S K,LU N,et al.Response to:Is optimizing gout treatment the key to closing the mortality gap in gout patient?[J]. Ann Rheum Dis,2017,77(1): e2 .
3、 李朝霞,戴冽,李谦华,等.痛风患者的疾病负荷与诊疗现状[J]. 广东医学,2015,36(19):3041-3044. 李朝霞,戴冽,李谦华,等.痛风患者的疾病负荷与诊疗现状[J]. 广东医学,2015,36(19):3041-3044.
4、 REINDERS MK, JANSEN TL.New advances in the treatment of gout:review of pegloticase[J]. Ther Clin Risk Manag,2010,6(1):543-550. REINDERS MK, JANSEN TL.New advances in the treatment of gout:review of pegloticase[J]. Ther Clin Risk Manag,2010,6(1):543-550.
5、 张智,王业辉.关节镜下清理术联合中药熏洗治疗痛风性膝关节炎的临床疗效观察[J]. 广州医药,2018,49(2):104-108. 张智,王业辉.关节镜下清理术联合中药熏洗治疗痛风性膝关节炎的临床疗效观察[J]. 广州医药,2018,49(2):104-108.
6、 GNANENTHIRAN S R,HASSETT G M,GIBSON K A,et al.Acute gout management during hospitalization:a need for a protocol[J]. Intern Med J,2011,41(8):610-617. GNANENTHIRAN S R,HASSETT G M,GIBSON K A,et al.Acute gout management during hospitalization:a need for a protocol[J]. Intern Med J,2011,41(8):610-617.
7、 WALLACE B,KHANNA D,AQUINO-BEATON C,et al.Performance of gout impact scale in a longitudinal observational study of patients with gout[J]. Rheumatol,2016,55(6):982-990. WALLACE B,KHANNA D,AQUINO-BEATON C,et al.Performance of gout impact scale in a longitudinal observational study of patients with gout[J]. Rheumatol,2016,55(6):982-990.
8、 SMITH E,HOY D,CROSS M,et al.The global burden of gout:estimates from the global burden of disease 2010 study[J]. Ann Rheum Dis,2014,73(8):1470-1476. SMITH E,HOY D,CROSS M,et al.The global burden of gout:estimates from the global burden of disease 2010 study[J]. Ann Rheum Dis,2014,73(8):1470-1476.
9、 张晶,刘建,龙丽,等. 血清降钙素原鉴别慢性痛风患者发热原因的价值[J]. 中华医学杂志,2015,95(31):2556-2559. 张晶,刘建,龙丽,等. 血清降钙素原鉴别慢性痛风患者发热原因的价值[J]. 中华医学杂志,2015,95(31):2556-2559.
10、 Roddy E,Choi HK.Epidemiology of gout[J]. Rheum Dis Clin North Am,2010,12:223-224. Roddy E,Choi HK.Epidemiology of gout[J]. Rheum Dis Clin North Am,2010,12:223-224.
11、 叶德福,林惠芳,张英根,等.超声诊断痛风性关节炎的临床价值[J]. 现代医院,2018,18(3):444-446. 叶德福,林惠芳,张英根,等.超声诊断痛风性关节炎的临床价值[J]. 现代医院,2018,18(3):444-446.
12、 VARGAS-SANTOS A B,CASTELAR-PINHEIRO G D R,COUTINHO E S F,et al. Adherence to the 2012 american college of rheumatology (acr) guidelines for management of gout:a survey of brazilian rheumatologists[J]. PLoS One,2015,10(8):e0135805. VARGAS-SANTOS A B,CASTELAR-PINHEIRO G D R,COUTINHO E S F,et al. Adherence to the 2012 american college of rheumatology (acr) guidelines for management of gout:a survey of brazilian rheumatologists[J]. PLoS One,2015,10(8):e0135805.
13、 NEOGI T,JANSEN TLTA,DALBETH N,et al.2015 Gout classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative[J]. Ann Rheum Dis,2015,74(10):1789-1798. NEOGI T,JANSEN TLTA,DALBETH N,et al.2015 Gout classification criteria:an American College of Rheumatology/European League Against Rheumatism collaborative initiative[J]. Ann Rheum Dis,2015,74(10):1789-1798.
14、 SINGH J A.Gout and comorbidity:a nominal group study of people with gout[J]. Arthritis Res Ther,2017,19(1):204 . SINGH J A.Gout and comorbidity:a nominal group study of people with gout[J]. Arthritis Res Ther,2017,19(1):204 .
15、 张雄峰,李正胜,刘正奇,等. 难治性痛风性关节炎的临床分析[J]. 中国骨与关节杂志,2017,6(8):611-614. 张雄峰,李正胜,刘正奇,等. 难治性痛风性关节炎的临床分析[J]. 中国骨与关节杂志,2017,6(8):611-614.
16、 FARGETTI S, GOLDENSTEIN-SCHAINBERG C, SILVA A A, et al.Refractory gout attack[J]. Case Rep Med,2012,2012(3):657-694. FARGETTI S, GOLDENSTEIN-SCHAINBERG C, SILVA A A, et al.Refractory gout attack[J]. Case Rep Med,2012,2012(3):657-694.
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