青年痛风患者686例临床特征分析

Analysis of clinical characteristics of 686 young patients with gout

目的探讨青年痛风患者发病的临床特点及相关危险因素。方法回顾性分析中国医科大学附属盛京医院2013年1月至2017年12月收治的686例青年痛风患者的临床资料,并与中老年痛风患者的临床资料进行比较。结果青年(≤44周岁)痛风患者比例较高,占53.26%,各组病程<10年者青年组最高(占89.07%)。首次受累关节分别为:第一跖趾关节47.42%、踝关节35.20%、膝关节15.23%。伴发疾病以脂肪肝为多(55.39%),其次为高血压(23.62%)。实验室数据显示,青年痛风患者血尿酸、白细胞、三酰甘油高于中老年组,而血肌酐、C反应蛋白、红细胞沉降率、总胆固醇较中老年组低;疾病主要诱发因素为饮酒(45.23%),其次为高嘌呤饮食(32.16%),具有相关家族史者所占比重大(22.16%),以高血压为多。结论青年痛风患者发病比例、病程<10年者增多,发病主要诱发因素为饮酒、高嘌呤饮食。常见伴发疾病为脂肪肝、高血压。

Objective To investigate the clinical features of and risk factors associated with gout in young adults.Methods The clinical data of 686 young patients with gout from Shengjing Hospital of China Medical University were retrospectively analyzed,and they were compared with the clinical data of middle-aged and elderly patients with gout.Results The proportion of gout patients(≤44 years old) was higher,accounting for 53.26% of the total cases.The group with the disease duration <10 years was the highest(89.07%).The first affected joints were the first metatarsophalangeal joint(48.06%),ankle joint(33.70%) and knee joint(15.37%).Fatty liver disease was the most common complication(accounting for 55.39%),followed by hypertension(accounting for 23.62%).Laboratory data showed that the levels of serum uric acid,white blood cells and triglycerides in young gout patients were higher than those in middle-aged and elderly groups,while serum creatinine,C-reactive protein,erythrocyte sedimentation rate and total cholesterol levels were lower than those in middle-aged and elderly groups.The main predisposing factors for disease were drinking(45.23%),followed by sorghum diet(32.16%),being with a family history(22.16%) and with high blood pressure.Conclusion The proportion of young patients with gout whose disease duration <10 years has increased,and the major predisposing factors are alcohol consumption and high-purine diet.Common complications are fatty liver and hypertension.