难治性痛风的临床特征及影响因素分析

doi:10.3969/j.issn.1006-7795.2022.06.021

摘要/Abstract

摘要： 目的分析并总结难治性痛风的临床特征及相关因素,为治疗难治性痛风提供临床经验。方法分析2016年1月至2020年1月在首都医科大学附属北京朝阳医院风湿免疫科住院治疗的148例痛风性关节炎患者的临床资料,分为难治性痛风组(44例)和非难治性痛风组(104例),分析难治性痛风的临床特征及其相关因素。结果 148例痛风患者中,难治性痛风患者占29.72%,所有痛风患者均未严格低嘌呤饮食,98.65%的患者既往未规律服用降尿酸药物。两组的年龄、体质量指数(body mass index, BMI)、痛风发作频率、累及关节数目、有无痛风石、是否饮酒相比较,差异均有统计学意义(P＜0.05)。两组在是否吸烟、有无痛风家族史以及性别方面,差异均无统计学意义(P＞0.05)。难治性痛风组合并高血压、糖尿病、冠状动脉粥样硬化性心脏病、肾功能不全的比例更高,与非难治性痛风组比较,差异均有统计学意义(P＜0.05)。两组患者肌酐、估算肾小球滤过率(estimated glomerular filtration rate, eGFR)、红细胞沉降率(erythrocyte sedimentation rate, ESR)、C-反应蛋白(C-reactive protein, CRP)比较,差异均有统计学意义(P＜0.05)。多因素Logistic回归分析结果显示,有痛风石、血尿酸浓度、痛风病程、累及关节数目是难治性痛风的相关影响因素(P＜0.05)。结论难治性痛风组患者多有饮酒习惯,ESR和CRP较高,合并症较多;难治性痛风与更高的血尿酸、累及更多的关节数目、更长的痛风病程及有痛风石相关。

关键词: 痛风, 难治性, 血尿酸, 达标治疗, 合并症

Abstract: Objective To analyze the clinical characteristics and related factors of refractory gout and provide clinical experience for the treatment of refractory gout. Methods The clinical data of 148 patients with gout who were hospitalized in the department of rheumatology and immunology, Beijing Chaoyang Hospital, Capital Medical University from January 2016 to January 2020 were analyzed. The patients were divided into refractory gout group (44 cases) and non refractory gout group (104 cases). Results Among 148 gout patients ,29.72% of them were refractory gout patients. All gout patients did not strictly take a low purine diet, and 98.65% patients did not regularly take drugs to lower uric acid.There were statistically significant differences in age, body mass index (BMI), frequency of gout attack, number of joints involved, presence or absence of tophus and whether drinking alcohol between the two groups (P<0.05). There was no significant difference in smoking, family history of gout and gender between the two groups (P>0.05).The proportion of refractory gout group with hypertension, diabetes, coronary heart disease and renal insufficiency was higher than that of non refractory gout group (P<0.05). There were significant differences in creatinine, estimated glomerular filtration rate (eGFR), erythrocyte sedimentation rate (ESR), and C-reactive protein (CRP) between the two groups (P<0.05). Multivariate Logistic regression analysis showed that gout stones, serum uric acid, duration and involved joints were the relevant influencing factors of refractory gout (OR>1, P<0.05). Conclusion The patients in the refractory gout group often drank more alcohol, had higher ESR and CRP, and had more complications. Refractory gout is associated with higher serum uric acid, more joints involved, longer gout course, and the presence of gout stones.

Key words: gout, refractory, serum uric acid, treat to target, complications

中图分类号:

R593

刘敏, 孟娟. 难治性痛风的临床特征及影响因素分析[J]. 首都医科大学学报, 0, (): 953-958.

Liu Min, Meng Juan. Clinical characteristics and influencing factors of refractory gout[J]. Journal of Capital Medical University, 0, (): 953-958.

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