Department of Medicine, Division of Rheumatology, Hospital of the University of Pennsylvania, Philadelphia, PA 19104, USA.
Int J Clin Pract. 2010 Feb;64(3):371-7. doi: 10.1111/j.1742-1241.2009.02188.x. Epub 2009 Nov 10.
There have been recent advances in the understanding of underlying mechanisms and treatment of gout and chronic hyperuricemia, making this an important time to review the current state of the disease. The goal of this article is to provide a practical review of the current standard of care as well as discuss some new developments in the management. There is an increasing prevalence of gout and hyperuricemia worldwide. Gout confers a significant individual and societal burden and is often under-treated. Appropriate diagnosis and treatment of acute gout should be followed by aggressive and goal-oriented treatment of hyperuricemia and other risk factors. Allopurinol remains as a first-line treatment for chronic hyperuricemia, but uricosuric agents may also be considered in some patients. Febuxostat, a non-purine xanthine-oxidase inhibitor, is a new agent approved for the treatment of hyperuricemia in patients with gout, which may be used when allopurinol is contraindicated. Gout and hyperuricemia appear to be independent risk factors for incident hypertension, renal disease and cardiovascular disease. Physicians should consider cardiovascular risk factors in patients with gout and treat them appropriately and aggressively.
近年来，人们对痛风和慢性高尿酸血症的发病机制和治疗方法有了更深入的了解，现在正是回顾该疾病现状的重要时刻。本文的目的是提供当前治疗标准的实用综述，并讨论一些管理方面的新进展。全世界痛风和高尿酸血症的患病率不断上升。痛风会给个人和社会带来巨大负担，且往往治疗不足。急性痛风的恰当诊断和治疗后，应积极且有针对性地治疗高尿酸血症和其他危险因素。别嘌醇仍然是慢性高尿酸血症的一线治疗药物，但在某些患者中也可考虑使用促尿酸排泄药物。非嘌呤黄嘌呤氧化酶抑制剂——非布司他，是一种新的治疗痛风患者高尿酸血症的药物，当别嘌醇禁忌时可使用。痛风和高尿酸血症似乎是新发高血压、肾脏疾病和心血管疾病的独立危险因素。医生应考虑痛风患者的心血管危险因素，并进行适当和积极的治疗。
