原发性痛风64例临床分析

Analysis of primary gout --A report of 64 cases

目的探讨社区原发性痛风的临床特征和防治要点。方法对社区106例原发性痛风患者的临床资料进行回顾性分析，并将其中64例离退休教职工患者（A组）与同期42例在职教工患者（B组）的临床资料进行对照比较。结果A组的血肌酐、总胆固醇、甘油三酯水平与B组比较差异有统计学意义（P〈0．01）；但血尿酸、血沉水平比较差异无统计学意义（P〉0.05）。A组合并肥胖症、高血压、高脂血症、冠心病的发生率与B组比较差异有统计学意义（P〈0．05）；但合并糖尿病、泌尿系结石的发生率与B组比较差异无统计学意义（P〉0．05）。结论①中青年人原发性痛风以血尿酸持续或波动性增高多见，老年人原发性痛风则以痛风性关节炎多见，其发生率较中青年高且症状有时不典型，红、肿、热、痛可能有部分缺如；②对部分痛风病人的诊断不能只看血尿酸水平，尤其对老年人不能以血尿酸正常而否定诊断，有时需反复检查；③通过健康教育和生活方式的干预可控制部分患者血尿酸水平、减少痛风性关节炎发生机率。

Aim To explore the clinical features and prevention of primary gout. Methods The data of 106 cases with primary gout in the community was analyzed retrospectively, and the clinical data of 64 cases who had retired （ group A） and 42 cases who were in service （group B） were contrasted. Results The differences between the levels of plasma creatinine, cholesterol and triglyceride in group A and those in Group B were statistically significant （P 〈0. 01 ） . However, there was no obvious difference in uric acid, blood sedimentation levels, which had no statistical significance （ P 〉 0. 05 ） . The differences between the occurrence rate of complications of obesity, hypertension, hyperlipemia and coronary heart disease in group A and those in group B were statistically significant （P〈0.01） . However, the differences between the occurrence rate of complications of diabetes and urinary system stones in group A and those in group B were statistically significant （ P 〉 0. 05 ） . Conclusion （1） Most of the middle-ages with primary gout suffer from persistent hematuria and wave elevation, while the old with primary gout suffer gouty arthritis, the occurrence rate of which is higher and the symptoms are not typical and there may not be redness, swollenness, fever and pain. （2）While diagnosing the patients, the level of uric acid can not be the only diagnostic factor, which is especially true of the old, and so the tests should be done repeatedly. （3）The level of uric acid can be controlled and the occurrence of gouty arthritis can be reduced through interference of health education and lifestyle.