Petersel Danielle, Schlesinger Naomi
Rheumatology Division, Department of Medicine, University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School, New Brunswick, New Jersey 08903-0019, USA.
J Rheumatol. 2007 Jul;34(7):1566-8. Epub 2007 Jun 15.
To record practice patterns of treatment of acute gout in hospitalized patients.
We performed a retrospective chart review of hospitalized patients diagnosed with gout.
Seventy-nine (43%) patients were diagnosed with acute gout during their hospitalization. Fifty-eight (73%) patients with acute gout were found to have a reduction in their glomerular filtration rate. Twenty patients (25%) underwent arthrocentesis. The most widely used drugs for acute gout were colchicine, n = 42 (53%), and nonsteroidal antiinflammatory drugs (NSAID), n = 40 (51%). Combination therapy was used in 52% of patients with acute gout. Thiry-six (86%) patients treated with colchicine and 32 (80%) patients treated with NSAID had renal failure.
Crystal analysis, the gold standard for diagnosing gout, was performed in only 25% of patients suspected of acute gout. Combination antiinflammatory agents are used in over 50% of patients despite the absence of evidence to support use of such combinations. Renal failure was present in 73% of patients with acute gout. Colchicine and NSAID should therefore be used with caution in these patients. Practice patterns vary widely and often appear to be in conflict with recommended diagnostic and treatment measures for acute gout.
记录住院患者急性痛风的治疗模式。
我们对诊断为痛风的住院患者进行了回顾性病历审查。
79名（43%）患者在住院期间被诊断为急性痛风。58名（73%）急性痛风患者的肾小球滤过率下降。20名患者（25%）接受了关节穿刺术。急性痛风最常用的药物是秋水仙碱，n = 42（53%），以及非甾体抗炎药（NSAID），n = 40（51%）。52%的急性痛风患者使用了联合治疗。接受秋水仙碱治疗的36名（86%）患者和接受NSAID治疗的32名（80%）患者出现肾衰竭。
仅25%疑似急性痛风的患者进行了痛风诊断的金标准——晶体分析。尽管缺乏支持使用此类联合用药的证据，但超过50%的患者使用了联合抗炎药。73%的急性痛风患者存在肾衰竭。因此，在这些患者中应谨慎使用秋水仙碱和NSAID。治疗模式差异很大，且往往似乎与急性痛风推荐的诊断和治疗措施相冲突。
