不同年龄起病痛风患者的临床特点分析

Analysis of clinical characteristics of patients with gout at different onset ages

收集2011年1月至2016年1月就诊于青岛大学附属医院门诊的痛风患者5 674例,按起病年龄分为青年组（≤44岁）3 058例、中年组（45～64）2 101例、老年组（≥65岁）515例,分别采集其临床资料并检测相关生化指标.结果显示,3组痛风男性患者所占比率高于女性,青、中、老年组男性痛风的所占比率分别为98.1%、93.4%、83.1%,且随着年龄的增加女性痛风患者的比率增加;青年组合并痛风家族史的比率显著高于中、老年组（P〈0.05）.老年组合并高血压、糖代谢异常的比率高于青年组和中年组（P〈0.05）,合并高脂血症、肥胖的比率低于青年组和中年组（P〈0.05）;老年组收缩压、血尿素氮、肌酐水平显著高于青年组和中年组（P〈0.05）;血尿酸、三酰甘油水平低于青年组和中年组（P〈0.05）.老年组合并肾功能不全的比率明显高于青年组和中年组（P〈0.05）;合并痛风石、肾结石的比率无明显统计学差异（P〉0.05）.3组痛风患者首发部位分布比较,差异有统计学意义（P〈0.05）,但各组均以第一跖趾关节为主.本研究结果提示不同起病年龄痛风的临床特点各不相同,临床上应区别对待.

According to the onset age, a total of 5 674 outpatients with gout admitted in the affiliated hospital of Qingdao University from January 2011 to January 2016 were divided into youth group （≤44 years, n=3 058）, middle age group （45～64 years, n=2 101）, and elderly group （≥65 years, n=515）.Their clinical and biochemical characteristics were analyzed.The results showed that the proportion of gout in the males in three groups was higher than that in the females.The proportions of gout in male youth, middle age, and elderly groups were 98.1%, 93.4%, and 83.1%, respectively.The proportion of gout in females increased with age.The proportion of gout family history in youth group was higher than that in middle age and elderly groups（P〈0.05）.The proportions of hypertension and impaired fasting glucose（IFG） in elderly group were higher than those in youth and middle age groups （P〈0.05）, with lower proportions of hypertriglyceride and obesity （P〈0.05）.The levels of systolic blood pressure, blood urea nitrogen, creatinine in elderly group were increased compared with youth and middle age groups （P〈0.05） while the levels of uric acid and triglyceride were decreased （P〈0.05）, with higher ratio of renal dysfunction （P〈0.05）.There were no differences in tophus and kidney calculi among three groups （P〉0.05）.The distributions of the onset joint among three groups revealed statistical difference（P〈0.05）, but the first plantar toe joint was mostly involved in each group.These results suggest that the clinical characteristics of patients with gout at different onset ages are not identical, should be treated differently.