Petraccia L, Fraioli A, Liberati G, Lopalco M, Grassi M
Department of Clinics and Medical Therapy, Umberto I Hospital, University of Rome, La Sapienza, Rome, Italy.
Minerva Med. 2008 Apr;99(2):203-12.
Gouty arthritis is estimated to be the most frequent manifestation of inflammatory arthritis in men aged over 40. Hyperuricemia occurs because of both exogenous and genetic factors, which are particularly influential in some populations such as Taiwan aborigines. Current understanding of the disease etiopathogenesis, its clinical manifestations and the stages of its progression are presented here. The criteria for a correct diagnosis of the disease are also reported, pointing out how to distinguish gout from clinical events of different origin but with a very similar symptomatology. A distinction is made between the agents used to relieve the acute attack (colchicine, nonsteroidal anti-inflammatory drugs, corticosteroids) and those used with the purpose of correcting hyperuricemia and preventing recurrences and complications (allopurinol, uricosurics). Mecha-nisms of action, administration routes, doses, side effects and contraindications of every drug are described. Besides pharmacological therapy, the importance and the efficacy of spa therapy is underlined. Finally, perspectives opened by gene therapy are mentioned.
痛风性关节炎据估计是40岁以上男性中最常见的炎性关节炎表现形式。高尿酸血症的发生是由外源性和遗传因素共同导致的，这在某些人群中影响尤为显著，比如台湾原住民。本文介绍了目前对该疾病病因发病机制、临床表现及其进展阶段的认识。还报告了该疾病正确诊断的标准，指出如何将痛风与起源不同但症状非常相似的临床事件相区分。区分了用于缓解急性发作的药物（秋水仙碱、非甾体抗炎药、皮质类固醇）和用于纠正高尿酸血症以及预防复发和并发症的药物（别嘌醇、促尿酸排泄药）。描述了每种药物的作用机制、给药途径、剂量、副作用和禁忌证。除了药物治疗外，还强调了温泉疗法的重要性和疗效。最后，提及了基因治疗带来的前景。
