女性初发痛风临床特点分析  

Clinical features analysis of female patients with the first gout attack

作　　者：王育凯[1] 黄源春[2] 

机构地区：[1]广东省汕头市中心医院风湿科,广东汕头515031 [2]汕头大学医学院第一附属医院检验科,广东汕头515031

出　　处：《中国医药导报》2013年第21期140-142,共3页China Medical Herald

基　　金：广东省汕头市重点科技计划项目(编号201009)

摘　　要：目的探讨女性初发痛风的临床特点,以增强临床医生对女性痛风的认识。方法回顾性分析了18例汕头市中心医院2008年12月～2012年11月期间门诊和住院就诊的初发女性痛风患者的临床资料(其中6例临床诊断困难个案,通过双能量CT扫描,发现尿酸盐晶体,经秋水仙碱抗炎治疗有效确诊)。与30例同期就诊的初发男性痛风患者资料和国内已报道的女性痛风资料进行比较,初步总结其临床发病特点。结果本组女性患者平均发病年龄(64.4±6.5)岁,大部分绝经后起病(88.9%)。男性发病年龄平均(55.4±12.2)岁(P<0.05)。女性痛风患者BMI(26.5±3.6)kg/m2,男性组(25.7±3.2)kg/m2(P>0.05),组间血尿酸水平比较差异无统计学意义(P>0.05)[(471.8±89.0)mmol/L比(489.7±97.3)mmol/L]。女性痛风患者饮酒比例明显低于男性(P<0.05)。首发部位,女性以踝关节常见,男性则以第一跖趾关节受累为主(P<0.05)。女性痛风患者合并高血压病和口服利尿剂比例明显高于男性患者(P<0.05)。本组患者的发病年龄、体重、起病方式与已报道的结果比较差异无统计学意义(P>0.05)。结论女性痛风多见于绝经后肥胖妇女,常合并多种疾病,口服影响尿酸代谢药物可能与其发病相关,且临床起病方式与男性痛风有一定差别。双能量CT扫描对于部分临床诊断有疑问的痛风患者不失为一种有价值的影像诊断手段。Objective To investigate the clinical characteristics of female gout, in order to enhance the understanding and appreciation of the clinical doctor to the disease. Methods 18 cases of female gouty （of which six cases were diag- nosed by dual-energy CT scans detected monosodium uric acid deposits） were retrospectively analyzed, and the data with 30 male gout and preliminary reported female gouty results were compared, the clinical features of the female gout were ultimately summarized. Results The mean age at onset of gout were （64.4±6.5） years in women, and （55.4±12.2） years in men （P 〈 0.05）. Majority of patients were postmenopansal （88.9%）. Mean BMI and uric acid level were （26.5±3.6） kg/g and （471.8±89.0） mmol/L in women respectively, while （25.7±3.2） kg/m2 and （489.7_±97.3） mmol/L in men. No significant differences were found （P 〉 0.05）. Alcohol played a less important role in development of gout in women than men （P 〈 0.05）. Female patients more often had ankle joint involved. Hypertension and diuretics using were more common in female than in male gout patients （P 〈 0.05）. The onset of age, body weight, most involved joint of onset of this group had no significant difference compared with the results reported （P 〉 0.05）. Conclusion The on- set of female gout commonly occurs at postmenopausal obese women, more co-morbidity with other diseases, more often use of drugs affecting uric acid metabolism, more often involvement of ankle. The findings indicate differences in the clinical features of gout arthritis between women and men. In addition, dual-energy CT scan may have potential value for the diagnosis of gout by identify monosodium uric acid deposits.

关 键 词：女性 男性 痛风 临床特点 双能量CT 

分 类 号：R589.7[医药卫生—内分泌]