Reporter Zhang Jiazhen
With the improvement of people's living standards and changes in diet structure, the prevalence of hyperuricemia and gout in China has increased year by year, and it has shown a trend of rejuvenation. Hyperuricemia has become the "fourth highest" after the "three highs" of hypertension, hyperlipidemia and hyperglycemia. According to statistics, the current prevalence of hyperuricemia in China is about 13.3%, and the prevalence of gout is about 1.7%.
Recently, the reporter learned from the Department of Clinical Immunology of Xijing Hospital of the Air Force Military Medical University that from the current situation of diagnosis and treatment of common chronic diseases, gout patients are gradually getting younger, and the promotion of standardized diagnosis and treatment of gout needs to be further strengthened.
Focus on gout rejuvenation
In the workplace, business socializing, pushing cups for cups; in life, attending parties, meeting friends with wine. Gout is closely related to lifestyle, such as eating a lot of nutritious foods such as meat and seafood on a daily basis and people who drink a lot of alcohol are more likely to suffer from gout. Speaking of gout, many people think that it is a disease that can only be obtained in old age, but as everyone knows, with the improvement of living standards, there are more and more young gout patients. In recent years, many adolescents have found that uric acid is significantly elevated during physical examination, and even gout attacks.
"The 'disease of wealth' such as gout is no longer the 'standard' of 'greasy' middle-aged people, and it is also more and more 'favored' teenagers." They do not have a history of overeating high protein and alcoholism, and the reason for hyperuricemia and gout is closely related to excessive consumption of fructose drinks, which poses a huge threat to their health. Therefore, to prevent and control the trend of youthful gout, we must start from avoiding drinking beverages containing too much fructose, and closely monitor the level of blood uric acid to achieve standard control. Jia Junfeng, deputy director of the Department of Clinical Immunology at Xijing Hospital of air force military medical university, said.
In the human body, the purines produced by food and self-metabolism are further metabolized into uric acid. Under normal conditions, uric acid has no negative impact on the human body, and even has certain benefits, but when uric acid is produced too much or when there is a disorder of excretion, it will cause hyperuricemia, which is the root of gout. Because gout is asymptomatic in the early stages, many people do not immediately find themselves sick. Currently, the physical indicator that directly responds to gout disease is blood uric acid. Therefore, in the physical examination, we should pay attention to whether our blood uric acid exceeds the standard, and once it exceeds the standard, we must start to pay attention to prevention.
Hyperuricemia and gout are complex diseases in which genetic and environmental factors work together, and are a polygenically related disease with a certain familial clustering phenomenon. "Clinically, some patients have long-term hyperuricemia, but they have not developed gout, which indicates that patients have susceptibility genes for gout. However, in the clinic, the occurrence of gout is more closely related to eating habits and lifestyle. Jia Junfeng said.
Let gout no longer be "painfully crazy"
The clinical features of gout are hyperuricemia, tophi deposition, acute and chronic arthritis caused by characteristic recurrent attacks, and in severe cases, joint mobility disorders and deformities. Among them, acute gout arthritis, is the most common first symptom of gout, the first attack, the vast majority of only a single joint, the first metatarsophalangeal joint is the most common, followed by the ankle, knee, wrist and elbow joints, late severe can lead to limb deformity or disability. During the onset of gouty arthritis, the urate crystals in the blood are deposited in the joint cartilage, joint capsule, synovium, ligament and subcutaneous tissue, etc., forming gout nodules, the pain in the affected area will be very intense, and the tissues around the joints will appear red, swollen, hot, painful and other symptoms.
The reason why it is called "gout" is because pain comes and goes like the wind, comes and goes quickly, but is prone to recurrence. Once gout becomes chronic, patients have to deal with tophi, joint deformities, kidney disease, and cardiovascular disease. "The treatment of gout is, first of all, to alleviate the patient's pain symptoms; secondly, the key is to control the patient's uric acid level and achieve standard treatment." Jia Junfeng said.
"The treatment of gout requires long-term adherence. Even if the gout condition is stable and the blood uric acid level is up to standard, the patient still needs to be reviewed regularly, and the drug should be discontinued under the premise that the doctor knows the condition and the doctor recommends that the drug be discontinued. Jia Junfeng mentioned that the main reason why it is difficult to cure at the moment is that the cooperation between patients and doctors is not high enough, and many patients have disappeared after taking the drug, and they have begun to relax their vigilance and even stop the drug without authorization, resulting in repeated attacks of gout.
Moreover, joint pain is a very common symptom, a common manifestation of many diseases such as rheumatoid arthritis and ankylosing spondylitis, and it is difficult for patients to distinguish. Jia Junfeng believes that the department of immunology can help patients analyze and consider from a systematic perspective and diagnose the diagnosis in a timely manner.
In addition, April 20 of each year is designated as "Gout Day for The Whole People", aiming to popularize the prevention and treatment of gout and hyperuricemia. Jia Junfeng introduced that the Department of Clinical Immunology of Xijing Hospital of the Air Force Military Medical University has set up a patient association to manage chronic diseases, organize patients to carry out targeted health education, and at the same time strengthen doctor-patient communication and promote disease treatment. The Department of Clinical Immunology has also set up a special outpatient clinic for gout to collect patient data and help diagnose and treat patients.
Shut your mouth and spread your legs
The most fundamental cause of gout is elevated uric acid, so in theory and practice, if uric acid can be controlled in a normal range, it can be completely cured. For the reason why gout is always repeated, Jia Junfeng analyzed that gout patients not only need to take medicine according to the doctor's instructions, but also the patient's living habits need to be controlled, in the final analysis, it is "control the mouth, step on the legs".
Gout patients should strictly control the consumption of animal hearts, livers, kidneys and high-purine foods such as seafood and meat, and try to eat as little or no food as possible. The second is that drinking alcohol is strictly prohibited, and for gout patients, alcohol is a taboo to drink. Among all kinds of alcohol, beer is the most likely to cause gout, followed by spirits, whether it is a large amount of alcohol at one time, or a small amount of alcohol for a long time, which will induce gout attacks. Gout patients are best to drink more water, the daily water supplement to drink boiled water mainly, boiled water without purine components, not only can drink a lot, but also make every day have sufficient urine volume, thereby promoting uric acid excretion.
The characteristic of gout is that the affected area will produce a sharp pain sensation, so many ordinary gout patients dare not take the form of exercise to improve, for fear of aggravating the condition. Jia Junfeng said that proper physical exercise not only helps the recovery of the disease, but also helps to prevent the recurrence of gout.
It is often said that summer is the season of "beer + crayfish". However, when you are addicted, a "revolution" may also be brewing inside your body. Jia Junfeng stressed that if you want to avoid gout, people who like seafood, animal offal and good wine must keep their mouths shut. Otherwise, it may be that one day gout will be "unexpected, accompanied for life", and it will require a long period of medication treatment. But because gout is rooted in hyperuricemia, if uric acid is controlled within the normal range, gout can be well controlled. From this point of view, gout is also considered to be a rheumatism that can be "cured".
Author: Zhang Jiazhen
Source: Shaanxi Daily