The basics of gout _ three AI Tong Medicine Museum

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Mainly because of the enhanced nucleic acid metabolism, resulting in increased blood uric acid. 2. reduce the excretion: low drain on nucleic acid metabolism in patients with type and not reinforced, mainly for renal excretion of hypothyroidism, uric acid excretion analyses by elevated serum uric acid levels. Judgment of uric acid excretion produces too much and declined method has the following four methods: 1. 24-hour urinary uric acid in the urine of quantitative determination of the normal uric acid excretion < 800mg/day (General food) or < 600mg/day (low purine diet) in the case of excretion of bad type. Normal urinary uric acid excretion <800mg/��(��ʳ)��gt; 600mg/day (low purine diet) is generating excessive 2. uric acid clearance rate (Cua) determination of Cua > 12.6ml/belong to generate excessive-, < 6.6ml/min can be judged as excretion reduce type. 3.Cua and creatinine clearance rate (Ccr) ratio determination that is 100 per cent of the Cua/Ccr��, if 10% is generated > excessive, 5 per cent in the case of excretion < reduce type. 4. free urinary uric acid/creatinine ratio if > 1.O is generating excessive-, < 0.5 can determine for excretion reduce type. Symptoms of gout: uric acid salt (1) (2) and nephropathy gouty arthritis is not related to the severity. (3) urinary stones (4) acute obstructive nephropathy (5) gout: also known as gout nodule, uric acid in the body is internal, the excessive rise over its saturation of a certain parts of the body in white Crystal precipitation. Clinical diagnosis of gout: 1, gout x-ray: bone and joint for gout patients often suffer. X-ray usually as understanding gout patients have no bone joint involvement of preferred imaging methods. 2, early diagnosis of gout <1> clinical diagnosis of acute gout of standards: in arthritis acute onset of a few hours, every 1 to 2 hours of colchicine 0.5 ~ 1mg, if acute gout, generally taking 2-3 times, joint pain, now not even enough to travel from. ≪2> United States standard proposed by rheumatic Association, the following symptoms have 6, can be diagnosed as ventilation: (1) 1 more acute arthritis attacks. �� inflammation in the body at peak levels in 1 day. �� single arthritis attacks. �� observed joint redness. �� first metatarsal or swelling joint pain. �� unilateral attack involving the first metatarsophalangeal joint. �� unilateral attack involving the tarsal joints. �� suspicious of gout. �� hyperuricemia. �� intra-articular swelling of asymmetric x-ray examination. �� cortical bone by bone cyst without erosion. �� Arthritis disease outbreaks, synovial fluid microbial culture-negative. �� typical gout foot, that is, first metatarsophalangeal arthritis, with soft tissue swelling around the joints. 3. check the test first, blood, urine and erythrocyte sedimentation rate ESR 1. complete blood count and check the acute stage, elevated white blood cell count, often (10-20) �� 109/L, rarely exceeds 20 �� 109/L. Decreased renal function may have mild to moderate anemia. Increased erythrocyte sedimentation rate, usually less than 60mm/h. 2. routine urine check course early general no change, involving the kidneys may be proteinuria and hematuria, pus urine, see tube-type; concurrent nephrolithiasis, visible clearly can see acidic urine, urinary stones. Second, the determination of uric acid generally consider that the use of the determination of serum uric acid enzyme, male 416 �� m o l/L (7mg/dl), female > 357 �� m o l/L (6mg/dl), a diagnostic value. III. determination of urinary uric acid in the purine diet and not taking drugs affecting uric acid excretion, normal male adult urinary uric acid 24h does not exceed the total 3.54mmol/(600mg/24h). Primary gout patients discharged from urinary uric acid 90% less than 3.54mmol/24h. Therefore the normal urinary uric acid excretion, cannot exclude the urinary uric acid in gout, but greater than 750mg/24h, prompting the excessive uric acid, especially non-Nephrogenic secondary gout and hyperuricemia, urinary uric acid also significantly increased. IV. joint cavity puncture check (I) the polarized light microscopy (ii) General Microscopy (iii) determination of the spectrophotometer (4) purple acid Amine (murexide) test (5) test on the solubility of uric acid, gout nodule contents check six, x-ray radiography examination of seven, CT and MRI 4. gout treatment since metabolic disorder problems, if the control diet has not met with success, must be long-term drug control. Commonly used drugs in two categories: 1. to reduce uric acid synthesis: common drugs to allopurinol tablets, also called allopurinol. 2. increase uric acid excretion: common drug c Juan Shu, benzene bromide Coumarin in acute gout can take diclofenac, also known as 2 grams of Thiophene sodium. Colchicine is outdated drugs, on hepatic injury is relatively large, hepatic deficiencies are serious use in acute gout period, should not increase the amount of heparin drug control, otherwise the body the immune system to overreact. Gout of early detection and prevention: early detection of gout is most simple and effective way to do this is to detect blood uric acid concentration. (1) 60 years old, male and female and whether obesity. (2) obese middle-aged men and women after menopause. (3) high blood pressure, arteriosclerosis, coronary heart disease, cerebrovascular disease (e.g., cerebral infarction, cerebral outBlood) patients. (4) diabetes (type II diabetes). (5) the reasons for non-prescribed arthritis, especially middle-aged or older patients to single arthritis incidence as features. (6) calculus, particularly multiple renal calculi and bilateral renal patients. (7) a member of a family history of gout. (8) long and Aeromonas meat drinking habits of middle-aged or older people. Gout prevention: on advanced patients, gout can dissolve, you can improve joint function, renal dysfunction can also be improved. 30-year-old former appear early symptom of gout, his condition worse. roughly 20% of gout patients uric acid or calcium oxalate stones. complications have urinary obstruction and infection, and secondary renal tubulointerstitial disease. untreated for renal dysfunction often associated with hypertension, diabetes, or some other relevant, may further kidney disease causing cyanurate excretion obstacles, this not only speeds up the process of intra-articular pathology, at the same time is also the greatest threat to life. Gout considerations: gout patients except under the guidance of the medical application of appropriate drugs, in daily life also should note the following: (1) diet: �� pigs, cattle, as well as a variety of organ meats (liver, kidney, heart and brain), the amount of marrow, methotrexate, hanpiao should endeavour not to eat; shrimps, spinach, beans, to eat less; the majority of vegetables, fruits, milk and milk products, and so you can eat; the appropriate use of kelp on gout also has certain advantages. �� plenty of water, to make the daily urine volume remained at 2000ml above. �� avoid overeating or hunger. �� abstinence tobacco and alcohol, especially not alcohol. �� don't drink strong tea, coffee and other beverages. (2) the proper handling of inducing factors, disable or less affected uric acid excretion of drugs such as penicillin and tetracycline, etc. (3) obesity to positive weight loss, lose weight, this is very important to prevent gout occurred. (4) good rest.