Text/Figure Yangcheng Evening News all-media reporter Zhang Hua
Correspondent Wu Xiaodan Han Yurou
A bowl of old fire soup, a pot of boiling hot pot and the strongest cold air that is coming can be called "golden CP", plus a little wine, life is complete. However, who screams in the middle of the night with toes and joints in pain? Whether you are an old person in your sixties or seventies, or a young person in your twenties, you should never ignore hyperuricemia otherwise, it may make you "crazy" in pain.
When gout attacks, many people are unable to walk In Figure/Visual China
Early symptoms of hyperuricemia
Gout, which appears to be bone and joint pain, but the cause is also due to hyperuricemia caused by too much uric acid in the body, which is a metabolic disease. Professor Sun Jia, chief physician of the Department of Endocrinology and Metabolism of Pearl River Hospital of Southern Medical University, pointed out that under normal circumstances, the purines in food pass through a series of metabolic processes in our human body, and eventually convert into uric acid, and are excreted through the kidneys in urine. But once we consume too much of the high-purine diet, such as meat, seafood, old fire soup and animal offal, etc., or often drink beer, the liver will metabolize more uric acid, once the kidney load is exceeded, can not be completely excreted, it will cause uric acid accumulation in the body, hyperuricemia.
Most of the time, hyperuricemia does not attract your attention, because there are no serious symptoms of discomfort, and many people find high uric acid on physical examination. However, Professor Sun Jia reminded that you should never underestimate hyperuricemia, which is the invisible culprit that evolved into gout after a few years, and in severe cases, gouty kidney disease will lead to kidney failure and affect life expectancy.
Hyperuricemia to renal failure is only five steps
How does hyperuricemia evolve into gout? Professor Sun Jia made a figurative analogy: we sprinkled a handful of salt in a bowl of water and it dissolved quickly. But when we continue to add salt to it, the salt concentration in the water reaches a certain saturation, and the crystals of the salt will precipitate out of the water. In fact, uric acid is also a kind of "salt" that dissolves in our blood. When the concentration of uric acid in the blood becomes higher and higher, uric acid crystals begin to precipitate. These crystals often accumulate in the joint cavity, and over time they form tophi.
At this time, the macrophages in our body will run to engulf uric acid crystals and release a large number of inflammatory factors, resulting in local joint redness, swelling, heat and pain, which is what we often call gout. Gout often begins with joint pain in the foot, most commonly the metatarsophalangeal joint, followed by the ankle joint, and gradually spreads to the knee joint and the whole body joint.
The progression of tophi will cause joint deformities, limited mobility, and even bone destruction, pathological fractures, ulceration infection will also cause osteomyelitis, and it is more dangerous if sepsis or sepsis is secondary.
In addition, uric acid crystals can also cause urinary tract stones, as small as sediment-like stones, to kidney stones as large as a few centimeters, which may cause hematuria, low back pain, and eventually lead to kidney failure, and even uremia.
Professor Sun Jia said that from hyperuricemia to gout, it is not a short-term thing, most patients have 5-7 years of hyperuricemia before the onset of gout! It can be roughly experienced in the following five periods:
Gout loves to find seven groups of people
According to reports, the number of people with hyperuricemia in China has reached 177 million, and there are about 14.66 million gout patients, of which more than half are young and middle-aged. In addition, because estrogen has the effect of promoting uric acid excretion, men are more likely to develop hyperuricemia than women.
Some patients believe that gout only occurs once every few years and is not a big problem. In fact, Professor Sun Jia reminded that as we age, if we do not control the progression of uric acid in time, gout may change from once a few years to once a year, or even several times a year. Statistics show that 30% of gout patients without standardized treatment will develop tophi within 5 years.
Therefore, whether it is an increase in uric acid, or a friend who has had a gout attack, it is recommended to go to the hospital regularly for follow-up, monitor the uric acid situation and kidney function, early detection and early diagnosis and treatment, one can not be ignored!
Among the following seven groups of people who are most sought after by gout, Professor Sun Jia recommends that uric acid be included in the health screening program:
Do not take colchicine on your own for a long time
Glucocorticoids or colchicine are well-known drugs in many patients with gout. Professor Sun Jia encountered many patients in the outpatient clinic, because the effect was very good after taking, he took it for a long time without medical advice, resulting in serious adverse consequences such as secondary hypercortisolism or gastric bleeding, and even some because of long-term drug abuse increased the risk of tumorigenesis.
Therefore, Professor Sun Jia reminded that the drug must not be used arbitrarily if it is effective, and must be taken under the guidance of a specialist. The pertinence of each drug is different, some to control acute attacks, anti-inflammatory analgesia, alleviate symptoms, and some drugs are suitable for chronic long-term maintenance of uric acid at normal levels, such as non-bustistat that inhibits uric acid synthesis, and benzbromomarone that promotes uric acid excretion. If the acute phase of drugs is treated as a long-term treatment drug, it is likely to be counterproductive.
For example, the most common colchicine is a common drug for the treatment of gout in the acute stage, anti-inflammatory and analgesic is very effective, and gout can often be quickly relieved after taking it on the same day. But in fact, it does not really regulate the role of uric acid metabolism. The key is that the therapeutic dose of colchicine is very close to the toxic dose of the drug, so it must be taken with caution. Once diarrhea and other gastrointestinal symptoms appear, indicating that the drug has reached the dose of poisoning, it is necessary to stop immediately and reduce the dose the next day. In addition, colchicine promotes mitosis of cells, and long-term use of small doses may also increase the risk of tumorigenesis, because it should not be used as a long-term treatment drug.
Food purine content list quick collection
Finally, Professor Sun Jia once again stressed that although the drug is effective, strict lifestyle management can make the treatment more effective with half the effort!
Pay attention to diet: control purine intake, mainly low purine foods, medium purine food should be moderate, avoid the intake of high purine food. Check the food purine content table and see if you eat it right?
Drink more water, urinate more: It is advisable to drink boiled water, soda water containing sodium bicarbonate, and light tea, and the daily water intake is more than 2000mL.
Salt restriction: table salt can promote uric acid precipitation to induce and aggravate gout, and should be controlled at 2 to 5g per day.
Alcohol restriction: "Singing to alcohol, life is geometric" is certainly painful, but drinking alcohol, especially beer, is easy to induce gout, and alcohol should be restricted or even banned.
Weight control: Patients with overweight/obese gout help control uric acid by losing weight and prevent gout attacks. However, scientific weight loss should be carried out under the guidance of a doctor, and should not be blind.
Less "stimulation": cold, fatigue, strenuous exercise can make the renal vasoconstriction cause uric acid excretion to decrease, so we must pay attention to keep warm, reasonable work and rest, regular and appropriate exercise.
For patients with a history of gout, Professor Sun Jia suggested that blood uric acid should be maintained below 360 μmol/L for a long time to effectively prevent the occurrence of complications and delay progression. (For more news, please pay attention to Yangcheng Pie pai.ycwb.com)
Source | Yangcheng Evening News Yangcheng Pie
Editor-in-charge | Xu Zhangchao