Benecke Monika
MMW Fortschr Med. 2003 Aug 7;145(31-32):36-8.
In 99% of the cases, the underlying cause of gout is an inborn disorder of uric acid excretion. In addition to acute arthritis, clinical consequences include tophi, chronic destruction of joints, and ulcers. The patient is endangered by the frequent renal involvement, with hypertension and renal insufficiency. Furthered by such exogenous factors as overweight, high-calorie, purine-rich foods and immoderate consumption of alcohol, hyperuricemia may develop. Basic treatment comprises dietary measures and, up to a serum uric acid concentration of 8.5 mg/dl, should be the sole measure required. The aim is to achieve a permanent lowering of uric acid concentrations in the blood to < 6.5 mg/dl. This may be achieved by reduction of overweight (including regular exercise), an energy-adapted diet with only moderate amounts of fat, restriction--or, better, banishment--of alcohol, an ovolactovegetarian diet low in purine (care must be taken with high-purine vegetablesl), moderate intake of readily assimilated carbohydrates, and adequate amounts of calorie-free liquids.
在99%的病例中,痛风的根本病因是先天性尿酸排泄障碍。除急性关节炎外,临床后果还包括痛风石、关节慢性破坏和溃疡。患者常因肾脏受累而面临危险,出现高血压和肾功能不全。超重、高热量、高嘌呤食物以及过量饮酒等外源性因素会促使高尿酸血症的发生。基础治疗包括饮食措施,在血清尿酸浓度达到8.5mg/dl之前,应作为唯一所需措施。目标是使血液中尿酸浓度持续降低至<6.5mg/dl。这可以通过减轻体重(包括定期锻炼)、采用脂肪含量适中的能量适配饮食、限制——或者更好的是禁止——饮酒、低嘌呤的蛋奶素食饮食(高嘌呤蔬菜需谨慎食用)、适量摄入易消化的碳水化合物以及充足的无热量液体来实现。