痛风性关节炎降尿酸治疗启动时间对痛风性关节炎的影响  

Effect of Starting Time of Uric Acid Lowering Therapy on Gouty Arthritis

作　　者：闻秀珍 郑江霞[1] 刘圣徽 张细凤[1] WEN Xiuzhen;ZHENG Jiangxia;LIU Shenghui;ZHANG Xifeng(Jiujiang NO.1 People’s Hospital,Jiangxi Province,Jiujiang 332000,China)

机构地区：[1]江西省九江市第一人民医院,江西九江332000

出　　处：《中国医学创新》2022年第33期145-149,共5页Medical Innovation of China

基　　金：江西省卫生健康委科技计划项目(202140317)。

摘　　要：目的:探讨降尿酸治疗启动时间对痛风性关节炎患者治疗效果的影响。方法:选取2020年8月-2021年8月九江市第一人民医院风湿免疫科收治的痛风性关节炎患者100例,根据其是否在急性发作期进行降尿酸治疗分为观察组和对照组,各50例。观察组为急性发作24 h内给予降尿酸治疗,对照组则为急性期缓解后立即启动降尿酸治疗。随访6个月,比较两组患者的实验室检查指标、疼痛程度、生活质量、临床疗效、不良反应发生情况、痛风复发次数。结果:两组患者用药后的血清尿酸(UA)、C反应蛋白(CRP)、血沉(ESR)、血肌酐(Scr)均低于用药前(P<0.05),但两组用药前后的pH值比较,差异均无统计学意义(P>0.05);用药后,观察组患者的血清UA、CRP、ESR、Scr水平均低于对照组(P<0.05),但两组患者的pH值比较,差异无统计学意义(P>0.05)。两组患者用药后的VAS评分均低于用药前(P<0.05),生活质量评分均高于用药前(P<0.05);观察组患者用药后的VAS评分低于对照组(P<0.05),生活质量评分高于对照组(P<0.05)。观察组患者治疗的总有效率为88.00%(44/50),高于对照组68.00%(34/50)(χ^(2)=5.828,P<0.05)。两组患者的不良反应发生率比较,差异无统计学意义(χ^(2)=0.198,P>0.05),观察组患者3个月内痛风发作次数少于对照组(t=8.203,P<0.05)。结论:痛风性关节炎急性发作24 h内给予降尿酸治疗较急性期缓解后立即启动降尿酸治疗更能有效改善患者实验室检查指标,缓解患者疼痛,提升患者生活质量及临床疗效,减少患者痛风发作次数,从而促进痛风性关节炎患者恢复。Objective:To investigate the effect of initiation time of uric acid lowering therapy on patients with gouty arthritis.Method:A total of 100 patients with gout arthritis in Department of Rheumatology and Immunology,Jiujiang NO.1 People’s Hospital from August 2020 to August 2021 were selected and divided into observation group and control group according to whether they were treated with uric acid lowering in acute attack stage,with 50 patients in each group.All patients in the observation group were treated with uric acid lowering therapy within 24 hours of acute attack,while those in the control group were treated with uric acid lowering therapy immediately after acute remission.The patients were followed up for 6 months.The laboratory examination indexes,pain degree,quality of life,clinical efficacy,incidence of adverse reactions and recurrence times of gout were compared between the two groups.Result:The serum UA,CRP,ESR and Scr of the two groups after medication were lower than those before medication(P<0.05),but there was no significant difference in pH value between the two groups before and after medication(P>0.05);after medication,the serum levels of UA,CRP,ESR and Scr in the observation group were lower than those in the control group(P<0.05),but there was no significant difference in pH between the two groups(P>0.05).The VAS scores of the two groups after medication were lower than those before medication(P<0.05),the quality of life scores were higher than those before medication(P<0.05);the VAS score of the observation group after medication was lower than that of the control group(P<0.05),the quality of life score was higher than that of the control group(P<0.05).The total effective rate of the observation group was 88.00%(44/50),which was higher than 68.00%(34/50)of the control group(χ^(2)=5.828,P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(χ^(2)=0.198,P>0.05),the number of gout attacks in the observation group was less than that in the co

关 键 词：痛风性关节炎 降尿酸 疼痛 复发 

分 类 号：R589.7[医药卫生—内分泌]