女性痛风的临床特点及危险因素分析

Clinical features and risk factors of woman with gout

目的了解女性痛风的临床特点及相关危险因素。方法回顾性分析本院23例女性痛风患者的临床资料,并与149例男性痛风患者资料相比较。结果 23例女性痛风平均发病年龄(58.7±17.4)岁,149例男性痛风平均发病年龄(46.2±16.7)岁(P<0.01)。女性痛风BMI(22.4±3.2),男性为(26.8±4.6),P<0.05。女性痛风患者首发关节炎65.2%为下肢踝/膝关节,73.8%男性患者为足第一跖趾关节;病程中65.2%女性患者上肢关节受累,77.9%男性患者足第一跖趾关节受累。52.2%女性痛风患者伴发冠心病,而男性组仅为21.5%(P<0.05)。56.5%女性患者服用利尿剂、阿斯匹林或化疗药物。痛风结晶、尿酸性肾病、高脂血症、高血压病及糖尿病两组间差异无统计学意义。结论女性痛风患者发病年龄较大,体型偏瘦,多服用利尿剂等药物;以下肢踝及膝关节首发多见,多累及上肢关节;易伴发冠心病,应引起临床重视。

Objective To evaluate the clinical features and risk factors of woman with gout.Methods The clinical data of twenty-three women with gout were analyzed and compared with that of 149 males with gout.Results The mean age at onset of gout was（58.7±17.4） years in woman.Body mass index（BMI） was（22.4±3.2）.Although the initial manifestation of the disease was acute monoarticular arthritis,with involvement of the ankle or knee joint being more commonly observed in female patients（65.2%） than the male patients,and by contrast,with involvement of podagra being more frequently noted in the males（73.8%） than in the females（26.1%）.The females showed a higher frequency of upper limb joint involvement（65.2%）,and podagra was less frequently evident in the females（30.4%）.Coronary artery disease was more existed in the females（52.2%）.The females（56.5%） received more diuretics,aspirin or chemotherapeutics before gout onset.Conclusion The females showed less BMI,and seems to be more involved in the upper limb and more likely to have coronary artery disease.