What is the uric acid value on the physical examination report?Does high uric acid definitely lead to gout?How to eat a reasonable diet to be useful?
On the occasion of April 20, the "National Concern for Gout Day", Professor Huang Jianlin, director and chief physician of the Department of Rheumatology and Immunology of the Sixth Affiliated Hospital of Sun Yat-sen University (hereinafter referred to as "Sun Yat-sen Sixth Hospital"), and Lin Jinglin, director and chief physician of the Department of Traditional Chinese Medicine, said in an interview with a reporter from Yangcheng Evening News that "there is no gout without hyperuricemia", and maintaining the long-term standard of blood uric acid is one of the main principles of uric acid-lowering treatment for gout patients.
【Case】The courier brother has repeated gout attacks
"I have to deal with about 2,000 shipments a day, and I've had recurrent gout attacks for five years. Recently, the courier brother Xiao Liu came to the outpatient clinic of Zhongshan Sixth Hospital for three days due to swollen and painful thumb joint of his right foot.
Xiao Liu said that at first, it was mainly pain in the thumb of the foot, and then the ankle joint also began to hurt, and it occurred 5-6 times a year. Three years ago, Xiao Liu developed tophi on his ears, and his fingers had recurrent gouts and nodules.
Huang Jianlin said that because the blood uric acid has been at a high level, gout is prone to recurrence. The goal of urate-lowering therapy in patients with gout is serum uric acid
It is recommended to blanch vegetables and drink more than 2L of water every day
For the general confusion of the public about uric acid and gout, the expert answer is here!
Q: If there is no gout attack, what is the normal level of uric acid should be paid attention to and medication?
Answer: Hyperuricemia refers to the fasting blood uric acid level of more than 420 μmol/L twice a day in adults regardless of gender, regardless of gender, under the condition of normal purine diet.
If there is no history of gout attacks, urate-lowering drug therapy is started when serum uric acid ≥ 540 micromol/L, or ≥ 480 micromol/L and one of the following comorbidities: tophi or intra-articular urate deposition, uric acid nephrolithiasis or renal impairment, hypertension, impaired glucose tolerance or diabetes mellitus, dyslipidemia, obesity, coronary atherosclerotic heart disease, stroke, and cardiac insufficiency.
Q: Why does hyperuricemia tend to occur at a younger age?
A: With the social and economic development, people's lifestyle and dietary structure have changed, data show that the prevalence of hyperuricemia among adult residents in mainland China is 14.0%, of which the prevalence of young men (18-29 years old) is 32.3%, which may be related to unhealthy lifestyles such as high work pressure, eating out habits, lack of physical activity and high fructose intake. For example, many young people nowadays enjoy drinking beverages, most of which contain fructose.
Q: What are the dietary recommendations for uric acid control?
Answer: It is encouraged to eat more vegetables, preferably without oil, blanched and eaten, and eggs and low-fat, skimmed milk and its products are also encouraged to be eaten. Limit the consumption of beef, lamb, pork, purine-rich seafood, flavored sugar, desserts, seasoned salt (soy sauce and sauce), wine, and fruit wine. Avoid fructose-containing beverages, animal offal, liquor, beer, and rice wine. It is recommended to drink more than 2L of water per day.
Question: Cantonese people like to make old and beautiful soup, is it true that all soups will cause high uric acid?
Answer: Traditional Chinese medicine pays attention to syndrome differentiation and treatment, considering the individual's constitution and the stage of symptoms. It is true that soup stock will have a little effect on high uric acid, but ingredients such as yam and poria cocos that strengthen the spleen and promote dampness, as well as warm ingredients can balance the cold ingredients. How to make soup reasonably and scientifically, it is recommended to recuperate according to personal physique, and consult a Chinese medicine practitioner if necessary.
Q: Does hyperuricemia necessarily lead to gout?
A: The incidence of gout is closely related to the level of blood uric acid, and it can be said that there is no gout without hyperuricemia. The fluctuation of blood uric acid is too "drastic" and many times can trigger a gout attack. Only about 1 in 10 people with hyperuricemia will get gout.
Q: Are there any signs of a gout attack?
A: Most patients have no symptoms before the onset of the disease, and some patients have aurors such as fatigue, malaise and local tingling in the joints before the onset of the disease. At the first attack, the joints and surrounding soft tissues are red, swollen, warm, and tender, and more than 50% of the joints between the thumbs and soles of the feet occur on their own, and generally resolve spontaneously within 1-2 weeks. Recurrent patients have a gradual increase in joint pain, and severe cases may also have fever, chills, fatigue, palpitations, etc., if you feel unwell, please seek medical attention in time.
Q: Can gout be cured and what kind of medicine works?
A: The principle of acute treatment is to quickly control joint inflammation and pain. Start at small doses, colchicine and nonsteroidal anti-inflammatory drugs (eg, celecoxib, etoricoxib). Short-term anti-inflammatory therapy with corticosteroids may also be considered when treatment is contraindicated or inadequate. At present, there is no complete cure for gout.
Q: If uric acid is high, can it be lowered by paying attention to your diet?
A: Uric acid is the end product of purine metabolism in the human body, 80% of which is produced endogenously, and another 20% comes from diet. If you still don't meet the target after trying to control your diet, it may be related to metabolic problems in your body, as well as genetic factors.
Q: Do I need to continue taking medication if my pain is relieved or I have no symptoms?
A: Generally speaking, drug treatment must be controlled for a long time, and continuous compliance with blood uric acid is the main treatment principle, and after stopping urate-lowering drugs, the blood uric acid of most patients will rise again. At the same time, it is emphasized that patients receiving medication must also receive healthy lifestyle interventions. There are also some patients who have successfully lost weight by adjusting their lifestyle and strengthening exercise, and it is possible to control the blood uric acid at a more ideal level, and there is a possibility of stopping drug treatment. It is recommended to taper the dose gradually and increase monitoring. Retake the medication if necessary.
Text: Reporter Zhu Jiale, correspondent Luo Wei, Jian Wenyang, Huang Chunyan