家系痛风与散发痛风的临床特点研究

STUDY ON CLINICAL CHARACTERISTICS OF FAMILIAL AND SPORADIC GOUT

目的分析家系和散发痛风临床特征,为痛风的分型、治疗和预后判断提供依据。方法对比分析85例家系痛风病人和300例散发痛风病人的临床特征及生化特点。结果家系痛风病人痛风的初发年龄明显低于散发痛风病人(t=3.94,P<0.01)。两组年龄构成、性别构成、首次发作持续时间差异有显著意义(χ2=4.5～22.0,P<0.05)。家系痛风病人由高嘌呤饮食诱发、依赖药物缓解率、反复发作时疼痛程度明显加重、并发脂代谢紊乱所占比例明显高于散发痛风病人(χ2=4.5～16.9,P<0.05)。家系痛风病人无明显诱因、踝关节受累、并高血压所占的比例明显低于散发痛风病人(χ2=3.2～16.3,P<0.05)。家系痛风病人尿酸、肌酐、尿酸排泄分数、体质量指数明显低于散发痛风病人(t=2.2～3.8,P<0.05)。结论家系痛风病人发病年龄较早,发作时尿酸阈值较低,病情较重,因此要早期预防,一旦发作要及时治疗。

Objective To analyze the clinical characteristics of familial and sporadic gout in order to provide information for classification, treatment and prognosis of the disease. Methods The clinical and biochemical characteristics of 85 patients with familial gout and 300 with sporadic gout were compared and analyzed. Results The onset age of familial gout was significantly younger than that of sporadic gout （t = 3.94, P〈0, 01）. The differences in age and gender constitute, duration of the first attack between the two groups were statistically significant （X^2= 4.5-22.0,P〈0.05）. The percentage of patients being induced by purine food, with pain relief depending on drugs, worsening of pain during recurrence and complicated abnormal lipid metabolism were significantly higher in familial gout than in the sporadic （X^2=4.5--16.9, P〈0.05）. The percentage of patients with no obvious inducing factors, with ankle joint involvement, and hypertension were significantly lower in familial gout than in the sporadic （X^2 =3.2--16.3,P〈0. 05）. The serum uric acid and creatinine, the uric acid excretion fraction, and body mass index were significantly lower in familial gout patients than that in the sporadic （t=2.2--3.8,P〈0.05）. Conclusion The familial gout patients have early onset of the disease. During the attack, patients showed lower uric acid threshold, and experienced more severity of the disease. Early prevention should be emphasized and prompt treatment be given upon attack of the disease.