血尿酸持续达标治疗在难治性痛风中的意义

发布时间：2018-12-15 02:21

【摘要】：目的为促进难治性痛风患者血尿酸持续达标治疗的有效实施,引起患者及医护人员对血尿酸持续达标治疗的重视,形成规范化的治疗和管理措施提供科学依据。方法选取2013年6月-2015年6月海南省人民医院肾病风湿科住院的原发性难治性痛风患者92例为研究对象,对患者进行1年的治疗及随访,记录其治疗实施情况和疾病控制情况。结果在过去的1年中,有39例患者坚持实施了规范化血尿酸持续达标治疗,患者依从率为42.4%;经过1年的治疗,坚持血尿酸持续达标治疗的患者痛风发作频率较治疗前降低(Z=-3.020,P=0.003),受累关节数有所减少(Z=-2.453,P=0.014),痛风石体积缩小了(χ~2=5.786,P=0.013),有并发症的患者人数也明显减少(χ~2=4.083,P=0.039);1年后,坚持"血尿酸持续达标治疗"的患者痛风发作频率(Z=2.915,P=0.004)、受累关节数(Z=2.881,P=0.004)、痛风石体积缩小率(χ~2=6.321,P=0.012)均少于未坚持血尿酸持续达标治疗的患者。结论血尿酸持续达标治疗可有效降低痛风发作频率、减少受累关节数、缩小痛风石体积和减少并发症的发生,今后需通过加强健康宣教、建立患者的随访档案、及时监督患者复查、规范痛风的非药物和药物治疗和关注并发症,以推动血尿酸持续达标规范化治疗更好地实施。
[Abstract]:Objective to promote the effective implementation of sustained treatment of uric acid in patients with refractory gout, to arouse the attention of patients and medical staff to the treatment of continuous standard of blood uric acid, and to provide scientific basis for standardized treatment and management measures. Methods from June 2013 to June 2015, 92 patients with primary refractory gout in the Department of Renal Rheumatology, Hainan people's Hospital were selected as the study objects. The patients were treated for one year and followed up, and their treatment implementation and disease control were recorded. Results in the past one year, 39 patients persisted in the treatment of standardized serum uric acid, and the compliance rate was 42.4%. After one year of treatment, the frequency of gout attack and the number of involved joints were decreased in patients who insisted on continuous treatment with uric acid as compared with those before treatment (ZP0. 020, P0. 003), and the number of involved joints was decreased (ZT- 2. 453, P0. 014). The volume of gout stone was reduced (蠂 ~ 2 = 5.786), and the number of patients with complications was also decreased (蠂 ~ (2) 4.083) (P ~ (0.039). One year later, the gout attack frequency (Z _ (2.915), the number of affected joints (Z _ (2.881), the reduction rate of gout stone volume (蠂 ~ (2) = 6.321), the number of affected joints (P _ (0.004) and the rate of reduction of gout stone volume (蠂 ~ 2 ~ 2 ~ 6.321) were observed in the patients who insisted on "sustained treatment of uric acid". P0. 012) were less than those who did not insist on sustained treatment of uric acid. Conclusion continuous treatment with serum uric acid can effectively reduce the frequency of gout attack, reduce the number of affected joints, reduce the volume of gout stone and reduce the incidence of complications. Timely monitoring and reexamination of patients, standardization of non-drug and drug treatment of gout and attention to complications, in order to promote the implementation of sustained standardized treatment of serum uric acid.
【作者单位】：海南省人民医院肾病风湿科;
【分类号】：R589.7

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