急性痛风性关节炎合并下肢深静脉血栓的临床分析

Clinical features of patients with acute gout attack and lower extremity deep vein thrombosis

目的探讨急性痛风性关节炎合并下肢深静脉血栓形成(DVT)患者的临床特征。方法分析11例急性痛风性关节炎发作时合并下肢DVT的患者的临床资料。结果 (1)11例患者均为男性,年龄(67±17)岁。(2)痛风方面具有病程较久(平均14年)、血尿酸控制欠佳(10例升高)、复发性关节炎为主(9例)、累及多个关节(11例)和全身炎性反应活跃(11例)的特点。(3)下肢DVT方面具有均为静脉血栓栓塞首次发作(11例),远端孤立性下肢DVT为主(7例),主要表现为患肢肿胀和(或)疼痛(7例),也可无明显不适(4例),部分伴肺栓塞等其他静脉血栓栓塞(3例)的特点。结论病程较久、未接受规律降尿酸治疗的痛风患者,急性痛风性关节炎发作时如受累关节多、炎性反应重,需警惕合并下肢DVT的可能。

Objective To study the clinical profile of patients with both acute gout attack and lower extremity deep vein thrombosis（ DVT）. Methods The clinical manifestations of eleven patients with acute gout attack and lower extremity DVT were collected and analyzed. Results All of the eleven cases were male. The average age was（ 67 ± 17）years. The features of gout were with a longer course 14 years,poor controlled serum uric acid level,mainly relapsing arthritis,multiple joints involved and active inflammation reaction. The features of DVT were first episode,mainly distal isolated lower extremity DVT,presented as swelling and pain of the affected extremity or with no obvious symptom,and 3 cases with pulmonary embolism. Conclusion The patients with acute gout attack and the a longer course,poor controlled serum uric acid level,multiple joints involved and severe inflammatory manifestations should be alerted for the onset of DVT.