非遗传因素对痛风的影响  

The influence of non-genetic factors on gout

作　　者：张晓玮 王贵红[2] ZHANG Xiaowei;WANG Guihong(The Fifth School of Clinical Medicine of Anhui Medical University,Hefei,Anhui 230032,China;不详)

机构地区：[1]安徽医科大学第五临床医学院,安徽合肥230032 [2]安徽医科大学安庆医学中心风湿免疫科,安徽安庆246003

出　　处：《中华全科医学》2025年第3期477-480,529,共5页Chinese Journal of General Practice

基　　金：安徽省高等学校科学研究项目(2022AH040324)。

摘　　要：尿酸盐在血液中的蓄积和尿酸在细胞外液中的浓度饱和时形成的沉淀,促使尿酸在关节滑膜、滑囊、软骨以及其他关节组织中沉积,从而导致尿酸水平异常升高,衍生为一种可反复发作的炎症性疾病,即痛风。痛风的发病原因可能是嘌呤生物合成代谢增加,导致尿酸产生过多,或者是尿酸的排泄不足。尿酸是嘌呤代谢的中间产物,通过肾脏和粪便排出体外。当尿酸的产生过量或排泄不足时,尿酸浓度的增加会引起高尿酸血症。在没有急性关节炎等症状的情况下,高尿酸血症不能被称为痛风,只有在出现症状时才能被定义为痛风。痛风常与高尿酸血症并存,常与高脂血症、糖尿病、高血压、肥胖症、冠心病等多种慢性疾病并发。一些地区流行病学调查结果显示,我国痛风患病率估计在1.0%~3.0%,高尿酸血症患病率在5.5%~19.3%,而且还在继续上升。痛风对社会劳动力的影响不可小觑,因此有必要研究相关因素对痛风的影响,降低发病率和致残率。除遗传因素外,非遗传因素也占据非常重要的地位,本研究主要探讨与痛风可能相关的非遗传因素,包括年龄、性别、饮食、饮酒、吸烟、药物、合并症、季节、空气污染等,并综合考虑不同因素对痛风的发生或加重所产生的综合影响,为管理痛风高危因素提供可行的建议。The accumulation of urate in the blood and the precipitation formed when the concentration of uric acid in the extracellular fluid is saturated contribute to the deposition of uric acid in the synovium,bursa,cartilage,and other joint tissues,which results in abnormally high levels of uric acid,deriving from a recurring inflammatory disease that can be characterized by recurrent episodes,which is known as gout.Gout may develop as a result of increased purine biosynthesis,leading to excessive production of uric acid,or because of inadequate excretion of uric acid.Uric acid is an intermediate product of purine metabolism that is excreted through the kidneys and feces.When uric acid is either over-produced or under-excreted,the increase in uric acid concentration causes hyperuricemia.In the absence of symptoms such as acute arthritis,hyperuricemia cannot be called gout.It can only be defined as gout when symptoms are present.Gout often coexists with hyperuricemia and is often comorbid with a variety of chronic diseases such as hyperlipidemia,diabetes mellitus,hypertensive disorders,obesity,and coronary artery disease.According to the results of some regional epidemiological surveys,the prevalence of gout in China is estimated to be between 1.0%and 3.0%;the prevalence of hyperuricemia is between 5.5%and 19.3%,and continues to rise.And the impact of gout on the social labor force should not be underestimated,so it is necessary to study the impact of related factors on gout to reduce the incidence and disability rate.In addition to genetic factors,non-genetic factors also play a very important role,so the main focus of this study is to explore the non-genetic factors that may be associated with gout,which include age,gender,diet,alcohol consumption,smoking,medications,comorbidities,seasonality,air pollution,etc.The study will also consider the combined effects of different factors on the onset or exacerbation of gout and provide feasible recommendations for the management of high-risk factors for gout.

关 键 词：痛风 个人因素 医疗因素 环境因素 

分 类 号：R589.7[医药卫生—内分泌]