2020年美国风湿病学会《痛风管理指南》解读

2020 American College of Rheumatology guideline for the management of gout: an interpretation

痛风是最常见的炎性关节炎,其特征是尿酸盐增高和单钠尿酸盐(MSU)晶体沉积在组织中,引起关节炎、软组织肿块(即痛风石)、肾结石和尿酸盐肾病,对患者健康相关生活质量有重大影响。美国风湿病学会(ACR)于2020年6月发布了《痛风管理指南》。该指南提出了42条建议(包括16条强推荐建议),阐述了降尿酸治疗(ULT)的适应症、启动方法、持续管理、痛风发作、痛风患者和无症状高尿酸血症患者的生活方式和其他药物治疗策略。本文对其进行解读,以期为临床实践提供参考。

Gout is the most common inflammatory arthritis,which is characterized by elevated urate and monosodium urate(MSU)crystal deposition in tissues,leading to arthritis,soft-tissue masses(tophi),nephrolithiasis,and urate nephropathy.It has a major impact on health-related quality of life.The American College of Rheumatology(ACR)published ACR guidelines for the management of gout in June 2020,in which 42 recommendations(including 16 strong recommendations)were generated.The guideline described indications for urate-lowering therapy(ULT),approaches to initiating,ongoing management,gout flares,and lifestyle and other medication strategies in patients with gout and in individuals with asymptomatic hyperuricemia.This paper interprets it to provide references for clinical practice.