文档介绍：痛风Definitions因尿酸盐在血液中的饱和浓度为420moL/L(不分性别),超过此值可引起尿酸盐结晶析出,在关节腔和其他组织中沉积。因此,本共识将血尿酸水平>420mmo1/L(7mg/d1)mondisorderofuricacidmetabolismthatcanleadtodepositionofmonosodiumurate(MSU)crystalsinsofttissue,recurrentepisodesofdebointinflammation,,玩10年的流行病学研究显示,张国不同地区U病率存在较大的差刿,为546%-%,%-%,%-%%-%不等,-%,%-%.交痛风的患病率随车龄增長而增髙,男性髙唑,城市髙手农村,弪海高手內陆。%0estimatedglobalage-standardizedprevalenceofgoutin20102%ooverallprevalenceofself-reported,physician-diagnosedgoutinmen>30yearsoldandwomen>eFirstNewbiology:renalhandlingandthebasisofhyperuricemia约20%饮食来源核苷酸核蛋「约80%细胞来源核苷酸/核蛋白/5%towhoare腺嘌呤、鸟嘌呤werthe尿酸ortersfurOATPT1and42/3肾脏排泄约1/3肾外途经肠道、胆道等)排泄etubularenrsUF图2尿酸代谢示意图gssuchasprobenecid,losartanandlesinuradlowersUAandincreasethigelTE,-—尿酸盐晶体析岀——黏附、沉积于於节及周围软组织、肾小管和血管等部位-趋化中性粒胞、亘噬细胞-—释放致炎症因子—引起关节软骨、骨质、eFirst痛风意帐放作诱因高嘌呤饮食饮酒放疗急性痛(感染)药物Thelevelofuricaciddoesnotitselfprecipitategout;rather,acutechangesinthelevelofuricacidcausegoutHistorv:)enonsetofextremepain,tenderness,andjointinflammation(red,warmswollen).mayhavefever,flu-likemalaiseHistoryofpresentillness(hpiprogressionvariablemayprogressthrough4stages(overmanyyears)%Iheeedsoffheatier图H出megmHistory:eacutegoutseverepain,erythema,andswelling,oftenbeginninginmiddleofnightorearlymorningandincreasinguntilpeakingwithin24-48hoursusuallyself-limitedwithspontaneousresolutionin314dayspatientsoftencannottoleratesocksorweightofbedsheetduringacuteattackandmaybeunabletosupportownweightabout90%>additionaljointsmaybeaffectedoverti(includingupReretre)andik-automaed3History:intercriticalorintervalgout痛风性关节炎发作间歇期intervalsbetweenattacksareintercriticalperiodssubsequentattacksu