皮下多发痛风石患者的临床特点及相关危险因素研究  

Clinical characteristics and risk factors for primary gout patients with multiple subcutaneous tophi

作　　者：刘甜[1] 马利丹[1] 程晓宇[1] 贾兆通[1] 陈颖[1] 李长贵[1] 孙瑞霞[1] Liu Tian;Ma Lidan;Cheng Xiaoyu;Jia Zhaotong;Chen Ying;Li Changgui;Sun Ruixia(Department of Endocrinology and Metabolic Diseases,The Affiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院内分泌与代谢病科,青岛266003

出　　处：《中华内分泌代谢杂志》2023年第11期950-954,共5页Chinese Journal of Endocrinology and Metabolism

基　　金：国家自然科学基金青年项目(81600601)。

摘　　要：目的探讨痛风患者合并多发痛风石的危险因素,为其早期防治提供临床依据。方法回顾性选取2017年9月至2021年9月于青岛大学附属医院痛风医学中心门诊初次就诊的原发性痛风患者,根据痛风石的数目分为多发痛风石组、单发痛风石组、无痛风石组,采集其临床资料,测定生化指标、尿pH值等。方差分析或卡方检验进行组间比较,多元logistic回归分析相关影响因素。结果多发痛风石组患者年龄、痛风病程、血压、血尿酸、血尿素氮水平,痛风阳性家族史、吸烟、饮酒、痛风发作次≥2次/年,及合并高血压病、心脑血管疾病、肾结石的比率明显高于单发痛风石组和无痛风石组,肾小球滤过率、尿液pH值、规律运动的比率明显低于单发痛风石组和无痛风石组。多发痛风石组累及指间关节或掌指关节245例(44.46%),上肢其余关节212例(38.47%),仅次于第一跖趾关节349例(63.33%)。多元logistic回归分析显示痛风病程、血尿素氮、血尿酸、痛风阳性家族史、饮酒、痛风发作次≥2次/年及合并高血压为痛风患者发生多发痛风石的危险因素。结论痛风病程长,血尿素氮、血尿酸水平高,痛风阳性家族史,痛风频发,饮酒,合并高血压的患者更易出现皮下多发痛风石。Objective To investigate the clinical characteristics and risk factors of multiple tophi among gout patients.Methods Gout patients treated at Affiliated Hospital of Qingdao University from September 2017 to September 2021 were included retrospectively.According to the number of tophi,the patients were divided into the multiple tophi group,the single tophi group and the non-tophi group.Clinical data were collected,biochemical indices and urine pH value were determined.One-way ANOVA or Chi-square test was used to compare groups,and multivariate logistic regression was used to analyze the risk factors.Results The age,disease course,blood pressure,serum uric acid,urea nitrogen,and the rate of family history,smoking,drinking,gout attacks≥2 twice per year,hypertension,cardio-cerebrovascular diseases,kidney stones in the multiple tophi group were significantly higher than those in the single tophi group and the non-tophi group.The glomerular filtration rate,urine pH value and the rate of regular exercise were significantly lower than those of single tophi group and non-tophi group.In the multiple tophi group,245 cases(44.46%)were involved in the interphalangeal joint or metacarpophalangeal joint,212 cases(38.47%)were involved in other joints of the upper limb,which was second only to the first metatarsophalangeal joint(349 cases,63.33%).Logistic regression analysis showed that the course of disease,urea nitrogen,serum uric acid,positive family history,drinking,gout attacks≥twice per year and hypertension were the risk factors for multiple tophi in gout patients.Conclusion Patients with a long disease course,elevated uric acid,high urea nitrogen,positive family history,alcohol consumption,frequent gout flare and hypertension are more likely to develop multiple tophi.

关 键 词：痛风 痛风石 多发 危险因素 

分 类 号：R589.7[医药卫生—内分泌]