受访专家/广州医学院第三附属医院血液风湿科副主任医师 张建瑜

Guangzhou medical college of experts/the third affiliated hospital of doctor of vice director of blood FengShiKe ZhangJianYu

　　文/羊城晚报记者 张华 通讯员 刘丹 黄贤君

Wen/Yang cheng evening news reporter correspondent zhang hua HuangXianJun separately

　　中秋、国庆，节日接踵而至，应酬增多。喝酒吃肉，对于尿酸高的人来说，很容易诱发痛风。风湿科专家称，尿酸高的人群，尤其要注意避免高嘌呤饮食，同时还应积极治疗高尿酸血症，否则痛风的发作会越发频繁，久而久之还会出现痛风石、关节畸形，并发尿路结石甚至肾功能不全等重大疾病。

Mid-Autumn festival/National Day,Festivals follow,Increased with.Drinking eat meat,For uric acid high people,Very easy to cause gout.FengShiKe experts say,The crowd of high uric acid,Pay particular attention to avoid high purine diet,At the same time should also actively treating hyperuricemia,Or the gout attack will be all the more frequent,As time passes will also appear tophi/Joint deformity,Concurrent urinary stones and even kidney function not entire major disease.

95%为男性，近年呈年轻化趋势 95% for men,In recent years, a younger trend

　　广州医学院第三附属医院血液风湿科副主任医师张建瑜说，据统计，在临床上，痛风患者中95%为男性，初次发作年龄一般为40岁以后。也就是说，男性40岁后是患痛风的高发期，而且近年还有年轻化趋势，三十多岁痛风的患者也很常见。

The third affiliated hospital of guangzhou medical college FengShiKe blood of doctor of vice director of ZhangJianYu said,According to the statistics,In the clinical,Gout patients 95% for men,First, as a general rule, the age of onset after 40 years old.That is,Men after 40 years old is a period of gout,And in recent years and younger trend,More than 30 years old gouty patients is also very common.

　　张建瑜说，原发性痛风有一定的家族遗传性，约20%的患者有家族史。除去这个因素外，体内嘌呤代谢发生障碍而导致尿酸不能有效排泄，也是痛风发生的根本原因。一旦大量进食含嘌呤的食物后，尿酸就开始迅速升高，这就使得尿酸更容易在关节等组织中产生结晶，导致关节损伤，从而诱发急性痛风的发作。

ZhangJianYu said,Primary gout has certain familial transmissibility,About 20% of the patients have family history.Remove the outside factors,The body purine metabolism happens disorder and cause uric acid can't effective drainage,Gout is the fundamental reason.Once a large number of eating the food containing purine after,Uric acid began to rise rapidly,This makes more easily uric acid in joint and organization produces crystal,Lead to joint injury,Thus induced acute gout attack.

一夜之间，关节“红热肿痛” overnight,joint"Red heat swelling"

　　痛风发病前可无任何先兆，不过，常常会找到一些诱发因素，比如饱餐饮酒、过度疲劳、关节局部损伤、受冷受潮等。

Gout premorbid can without any aura,but,Often find some induced factors,Such as square meal drinking/Excessive fatigue/Joint local damage/Damp cold yet firm such as.

　　一有了这样的诱发因素后，痛风就会在你毫无准备的时候来临，多在晚上或清晨突然起病，多数为剧烈疼痛，关节变得红、热、肿、痛。张建瑜指出，最常见的就是脚的大拇指，其次为踝、膝、腕、指、肘关节。疼痛于24-48小时达到最高峰。发生痛风的时候，多数人是无法忍受的，好像被“咬”般疼痛，不少病人会在半夜被痛醒。

A this induced factors,Gout will be in your coming unprepared,Many in the evening or early in the morning sudden onset,For most intense pain,Joints become red/heat/swollen/pain.ZhangJianYu pointed out that,The most common is the foot thumb,Secondly for ankle/knee/wrist/Refers to/elbow.Pain from 24 to 48 hours to peak.Occur when gout,Most people is intolerable,Seems to be"bite"Pain like,Many patients will be awake in the middle of the pain.

　　痛风发作时，如果不采取任何治疗手段，通常可以在7-10天内得到缓解。但是，如果对痛风不加治疗，那么其发作间隔期将会逐渐缩短，发作期将会逐渐拉长。有调查显示，首次痛风发作后，有62%的人一年后复发，78%的人两年后复发，84%的人三年后复发。张建瑜说，如果不治疗，有的人在第一年会发作1-2次，之后发作的机会就变得越来越频繁，久而久之会出现痛风石、关节破坏畸形，并发尿路结石，甚至是导致肾功能不全。

Gout onset,If we do not take any treatments,Can usually in 7 to 10 days ease.but,If the gout don't cure,Then the attack interval would gradually shorten,Episode would gradually spin.Research has shown that,For the first time after a gout,62% of people a year later recurrence,78% of the people after two years recurrence,84% of the people after three years recurrence.ZhangJianYu said,If not treated,Some people in the first year attack 1-2 second,After the opportunity to attack becomes more and more frequent,As time passes can appear tophi/Joint destruction deformity,Concurrent urinary stones,Even cause renal insufficiency.

发作时先止痛，再慢慢降尿酸 First onset pain,Then slowly drop uric acid

　　在痛风急性发作的时候，患者和一些非专科医生常常误认为应马上服用降尿酸药物，结果却发现越是降尿酸，关节却越发肿痛。

In the acute gout attack time,Patients and some FeiZhuanKe doctors often mistaken for shall immediately take fall uric acid drug,The results found that the more drop uric acid,But they sore joints.

　　对于痛风患者来讲，痛风是一个表面的现象，而体内的尿酸过高才是疾病的根本原因。尿酸不高，自然不会有尿酸的结晶，也就不会有临床上痛风的症状了。因此，临床医生在治疗急性发作病人的时候，首先要考虑的是止痛，也就是要先治标。此时，多会使用足量非甾体抗炎药、小剂量秋水仙碱、适量糖皮质激素等，迅速减轻关节疼痛和肿胀，或者给关节冰敷。

For gout patients speaking,Gout is a surface phenomenon,And the body high uric acid is the root cause of the disease.Uric acid is not high,Nature will not have the crystallization of uric acid,There won't be clinical symptoms of gout.therefore,Clinical doctors in the treatment of acute attack the patient's time,The first consideration is pain,Also is to first take temporary solution.At this time,Will use enough non-steroidal anti-inflammatory drug/Small dose of colchicine/Right amount of glucocorticoid hormone, etc,Quickly reduce joint pain and swelling,Or give joint ice.

　　在急性期过后，降尿酸就成为主要任务，因为只有尿酸降到正常了，才会从根本上将痛风治疗好。

In the acute stage,Drop uric acid will become the main task,Because only uric acid to normal,Will the root of gout treatment will be good.

　　Tips：　　 tips:

　　1、不痛时，仍需要治疗 1/When pain,Still need treatment

　　很多痛风患者关节不痛的时候，就不到医院就诊，也不进行尿酸等检查和治疗。关节痛一发作，就吃些止痛药。长此以往，痛风将对关节、肾脏造成不可逆的损害。

A lot of gout patients joint pain of time,Will not hospital,Don't for uric acid, such as examination and treatment.Joint pain a seizure,Eat some painkillers.In the long run,Gout will joint/Kidney causes irreversible damage.

　　张建瑜认为，高尿酸血症的患者，在没有痛风发作的期间也应该平稳降尿酸，降尿酸药从小剂量开始逐渐增量，纠正高尿酸血症，使既往在关节间隙中的结晶完全排出，从而预防痛风发作及其并发症。

ZhangJianYu think,Hyperuricemia of patients,In no gout attack period should also be stationary drop uric acid,Drop uric acid from drug dosage gradually began to increment,Correct hyperuricemia,Make always in joint space of crystallization complete discharge,So as to prevent gout attack and its complications.

　　2、饮食控制 2/Diet control

　　痛风患者应采用低热能膳食，保持理想体重，同时，避免高嘌呤食物。含嘌呤较多的食物主要包括动物内脏、沙丁鱼、蛤、蚝等海味及浓肉汤，其次为鱼虾类、肉类、豌豆等。而各种谷类制品、水果、蔬菜、牛奶、奶制品、鸡蛋等含嘌呤最少。患者要严格戒饮各种酒类，因为酒精饮品会导致血清尿酸值上升，尤其是冰与啤酒，两者加在一起，对痛风患者往往有一触即发的恶果。患者每日饮水应在2000ml以上，以利于尿酸排出。

Gout should be used in patients with low-calorie diet,Keep ideal weight,At the same time,Avoid high purine food.Contain purine more food mainly includes the animal internal organs/sardines/clam/Oyster, etc seafood and thick soup,Secondly for fish and prawn class/meat/peas.And all sorts of grain products/fruit/vegetables/milk/Dairy products/Eggs contain purine at least.Patients must strictly abstinence from all kinds of wine,Because alcohol can lead to serum uric acid value rise,Especially ice and beer,The two mixed together,For gout patients often have hair-trigger consequences.Patients daily drinking water should be in more than 2000 ml,For uric acid discharge.