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How to prevent and treat gout, we all say: "Shut your mouth, step on your legs".
The Second People's Hospital of Guangdong Province previously received such a patient, an 18-year-old high school student Xiao Hai (pseudonym) because of drinking too much milk tea caused an acute attack of gout, the joints of his hands and feet were covered with white "stones", and his feet were swollen and he could not walk!
Under the treatment of rheumatology and immunology experts, Xiao Hai strode out of the hospital, "Never drink milk tea again!" He said.
01 Keen on milk tea, 18-year-old joints full of "stones"
Xiaohai, 18, is from Gaoming, Foshan, Guangdong Province, and is a high school student. Usually there is no other hobby, that is, I like to drink milk tea. "Usually every 2 days to drink 1 time, 1 cup a day will also be." Xiao Hai said.
However, because of this little hobby, Xiao Hai became ill a few years ago, and when he had a seizure, he screamed in pain and could not walk, and what was even more shocking was that the joints of his hands and feet were covered with white "stones".
(Image courtesy of Guangzhou Daily)
It turned out that Xiaohai was drinking too much milk tea that led to gout attacks and the formation of tophi.
Zheng Shaoling, attending physician of the Department of Rheumatism and Immunology of the Second People's Hospital of Guangdong Province, explained that the milk tea that Xiaohai loves to drink is a high-sugar soft drink, and after the high fructose component enters the human body, too much uric acid will be produced during the metabolic process, and gout will come to the door.
"The first time I came to my clinic, Xiaohai's limbs were already covered with tophi and he couldn't walk."
"Uric acid is particularly high, up to 900 μmol/L. We immediately arranged anti-inflammatory and uric acid-lowering therapy, temporarily stabilized the blood uric acid level to 400 μmol/L, and now slowly can stand and walk. In the follow-up, we will continue to actively lower uric acid for him, and strive for the tophi on the joints to gradually dissolve and become smaller or even disappear. Zheng Shaoling told reporters.
In fact, as early as a few years ago, Xiaohai already had a history of gout attacks, but he did not take medicine regularly and did not avoid eating. "I remember that day was back from playing, the right ring finger was painful and swollen, and it was not good for a few days, so I went to the local hospital to check: uric acid was very high, it could be gout. Because it was not very serious at that time, the doctor prescribed medicine and told him to pay attention to diet and weight control and went home. After that, I have long forgotten the doctor's advice, I should eat and drink, and the gout stones on my hands and feet quietly grow out, and now that I think about it, I really regret it. Xiao Hai said.
On July 14, after the treatment of the provincial second medical doctor team, Xiaohai was finally discharged from the hospital, he was walking out, after this time, he said: "No longer drink milk tea, will also take good medicine, control diet, regularly return to the hospital for review." ”
After 02 00 has been "recruited", the harm of gout should be known
According to the meta-analysis cited in the 2019 China Guidelines for the Diagnosis and Treatment of Hyperuricemia and Gout, the overall prevalence of hyperuricemia in China is 13.3%, and the prevalence of gout is 1.1%. In recent years, the incidence of gout/hyperuricemia has risen rapidly, and the characteristics of rejuvenation have become more and more prominent.
There have been news reports that a three-year-old girl in Huizhou, Guangdong Province, suffered from gout early due to a long-term high purine diet and a family history of gout...
There are many people who think that gout/hyperuricemia does not need to be taken seriously, as long as it does not attack gout, it does not matter whether uric acid is high or not. But in fact, the harm of gout/hyperuricemia to the human body should not be underestimated. Its harm is mainly reflected in the following five aspects:
1. Destroy the joints
The prevalence of gout increases with increased blood uric acid levels. A study followed for 2-10 years showed that when the blood uric acid > 360 μmol/L, 87.5% of patients had knee joint fluid urate crystals, while when the blood uric acid ≤ 360 μmol/L, only 43.8% of patients had knee joint fluid urate crystals.
2. Injured blood vessels
Hyperuricemia is an independent risk factor for hypertension. Studies have shown that for every 60 μmol/L increase in blood uric acid levels, the relative risk of hypertension increases by 13%.
3. Kidney injury
Hyperuricemia can lead to acute uric nephropathy, chronic uric nephropathy, and kidney stones, increasing the risk of renal failure. Studies have shown that for every 60 μmol/L increase in blood uric acid, the risk of chronic kidney disease (CKD) increases by 70% and the risk of deterioration of renal function increases by 14%. The prevalence of CKD in patients with normal blood uric acid levels is about 11%, while hyperuricemia with CKD is as high as 32.7%.
4. Chaotic metabolism
Hyperuricemia is also an independent risk factor for type 2 diabetes. Patients with hyperuricemia have a 95% increased risk of developing diabetes compared with normal hemauric acid. In addition, studies have also found that hyperuricemia is positively correlated with the incidence of lipid metabolism disorders such as obesity, hyperlipidemia, and hypercholesterolemia.
5. Reduced life
Studies have shown that the average life expectancy of patients with hyperuricemia and gout is 15-20 years shorter than that of normal patients. The 2010 Global Burden of Disease (GBD) Expert Group on Musculoskeletal Diseases and Risk Factors assessed the global burden of gout and suggested that the disabled survival years (DALYs) of patients with gout in 2010 were significantly worse than in 1990.
03 "Shut your mouth and open your legs", are you doing it right?
How to prevent and treat gout, we all say: "Shut your mouth, step on your legs". But what truths and misunderstandings are contained in this sentence? How do you do it correctly?
1. Refuse a high purine diet
It is generally believed that animal offal, soybeans, thick gravy, oysters, white-belted fish, carp, cod, sea bass, eels, shellfish, sardines, anchovies, beer, seaweed, shiitake mushrooms, bean fry and other foods have a high purine content and should be eaten as little as possible.
Sugary drinks should be drunk less, it is best to drink water and drink water!
2. Controlling diet is not a panacea!
A strict low-purine diet or vegetarianism alone is not enough to control uric acid!
Generally speaking, in the human body, only 20%-30% of the purines eaten through food are eaten. Most uric acid 70%-80% is stored in the body and metabolized by internal organs such as liver and kidneys. That is to say, simply by controlling the diet without taking other comprehensive measures, the blood uric acid level can only be reduced by 20%-30%.
Vegetarians, there are also many people suffering from gout. Some plant foods, such as coarse grains, asparagus, shiitake mushrooms, seaweed, bean sprouts, etc., although they are vegetarian vegetables, their purine content is relatively high, and regular consumption can also cause hyperuricemia.
3. There are tricks to alkalinize urine, and reasonable drinking water is helpful
When the urine pH is less than 5.5, the uric acid is supersaturated, the dissolved uric acid is less, when the pH is 6.2-6.9, most of the uric acid exists in the form of anionic uric acid, and uric acid stones are most easily dissolved and excreted with the urine.
Therefore, maintaining the urine pH value of about 6.5 is most conducive to the dissolution and excretion of uric acid stones. At present, the drugs commonly used in clinical alkalinization of urine are: potassium citrate and sodium citrate. Ensuring that you drink at least 2,000 mL of water daily, preferably with alkaline water, increases uric acid excretion and reduces the chance of urinary stones.
4. Advocate reasonable and moderate exercise to avoid "impulsive and blind movement"
(1) Avoid exercise during the onset of gout, and then exercise after the attack has subsided;
(2) Avoid participating in confrontational competition sports, and promote low-intensity, rhythmic and sustained aerobic exercise, such as walking, brisk walking, cycling, broadcast gymnastics, etc.;
(3) Maintain the appropriate amount of exercise, it is recommended to 30 minutes each time, 3-5 times a week, step by step, perseverance;
(4) Strenuous exercise is harmful to gout patients, which can increase patient sweating, reduce blood volume, renal blood flow, reduce uric acid, creatine and other excretion, and appear transient hyperuricemia. Increased lactic acid in the body after strenuous exercise inhibits tubular excretion of uric acid, which can temporarily increase blood uric acid.
(The news in the article comes from Guangzhou Daily All Media)
Source of this article: Medical Rheumatism and Nephropathy Channel
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