青少年痛风患者的临床特征初步分析  

Clinical characteristics in juvenile gout patients

作　　者：强孚勇[1] 汪筱莞 李志[1] 宣丹[1] 徐亮[1] Qiang Fuyong;Wang Xiaowan;Li Zhi;Xuan Dan;Xu Liang(Department of Rheumatology and Immunology,Affiliated First Hospital of Wannan Medical College,Wuhu 241000,China)

机构地区：[1]皖南医学院附属第一医院风湿免疫科,安徽省芜湖241000

出　　处：《中华全科医师杂志》2018年第11期918-920,共3页Chinese Journal of General Practitioners

摘　　要：为探讨青少年痛风的临床特征,回顾性分析2016年1-12月皖南医学院附属第一医院风湿免疫科门诊及住院的101例初诊痛风患者的临床资料及相关生化指标.按照年龄分为青少年组(41例)及成人组(60例),比较两组患者的BMI、生化指标、首发关节、病程及家族史等.青少年组患者BMI[(25.6± 1.3)kg/m2比(22.8± 1.0)kg/m2,t=-12.51]、TC[(5.55±0.51)mmol/L比(5.07±0.54)mmol/L,t=-4.44]、TG[(2.04±0.32) mmol/L比(1.83±0.39) mmol/L,t=-2.92]、血尿酸[606.0(541.0,641.0) μmol/L比502.5(447.5,542.2) μnol/L,Z=-5.65]及CRP[68.0(57.0,83.5)mg/L比46.0(36.0,59.8) mg/L,Z=-4.64]水平均高于成人组(均P＜0.01),但空腹血糖水平[(4.83±0.68) mmol/L比(5.74±1.23)mmol/L,t=4.31]、肿痛关节数[1(1,1)个比2(1,4)个,Z=5.45]及病程[1.0(0.5,4.0)个月比48.0(24.0,72.0)个月,Z=8.39]低于成人组(均P＜0.01).其肾小球滤过率高于成人组[(140.4±31.0)ml ·min-1·1.72 m-2比(77.7±22.5)ml/min,t=-11.81],而尿素氮[6.3(5.8,6.9) mmol/L比7.6(6.8,8.4) mmol/L,Z=5.89]、肌酐[65.1(56.2,75.1)μmol/L比874(78.5,98.4) μmol/L,Z=7.18]及胱抑素C[1.0(0.9,1.1)mg/L比1.9(1.5,2.0) mg/L,Z=7.66)水平低于成人组(均P＜0.01);与成人组相比,青少年组首发关节为第一跖趾关节的比例低、踝关节比例高,但差异无统计学意义(x2=3.434,P＞0.05);青少年组有痛风家族史患者的比例高于成人组(x2=6.174,P＜0.05),但有痛风石患者的比例低于成人组(x2=16.564,P＜0.01).提示青少年痛风临床特征与成人痛风相比有明显不同,青少年痛风患者的管理需要区别于成人患者.To analyze the clinical characteristics of juvenile gout,101 gout patients in Affiliasted First Hospital of Wanan Medical College from 2016 January to Decemder were divided into juvenile group (≤ 20 years,n=41) and adult group (＞20 years,n=60),the clinical data and related biochemical tests were collected.The body mass index (BMI),fasting blood glucose (FBG),TC,TG,uric acid,urea nitrogen,creatinine,cystatin C,glomerular filtration rate (GFR) and C-reactive protein (CRP),the first gout position,the duration of disease,the family history,the number of involved joints and the tophi were compared between two groups.Compared with the adult group,the juvenile group had significantly higher BMI [(25.6± 1.3) vs.(22.8± 1.0),t=-12.51)],TC [(5.55±0.51) vs.(5.07±0.54),t=-4.44),TG [(2.04±0.32) vs.(1.83±0.39),t=-2.92),uric acid[606.0 (541.0,641.0) vs.502.5 (447.5,542.2),Z=-5.65land C-reactive protein[68.0(57.0,83.5) vs.46.0 (36.0,59.8),Z=-4.64],while lower FBG [(4.83±0.68) vs.(5.74± 1.23),t=4.31)] and the number of involved joints[1(1,1) vs.2(1,4),Z=5.45].The GFR was higher in the juvenile group [(140.4± 31.0) vs.(77.7±22.5),t=-ll.81,P＜0.001)],while the urea nitrogen [6.3 (5.8,6.9) vs.7.6 (6.8,8.4),Z=5.89],creatinine [65.1 (56.2,75.1) vs.87.4 (78.5,98.4),Z=7.18] and cystatin C[1.0(0.9,1.1) vs.1.9(1.5,2.0),Z=7.66]were lower than those in adult group(all P＜0.01).The incidence of the first metatarsophalangeal joint involvement and the ankle joint involvement had no statistical difference between two groups (x2=3.434,P＞0.05).The proportion of family history of gout was higher in juvenile group (x2=6.174,P＜0.05)but the proportion of tophi was lower (x2=16.564,P＜0.01) than those in adult group.The characteristics of juvenile gout are significantly different with those of adult gout patients,so the juvenile patients should be managed differently from the adult patients.

关 键 词：痛风 青少年 疾病特征 

分 类 号：R589.7[医药卫生—内分泌]