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[痛风与心血管风险]

[Gout and cardiovascular risk].

作者信息

Němec Petr

出版信息

Vnitr Lek. 2014 Oct;60(10):893-901.

Abstract

Gout represents a heterogeneous group of metabolic disorders characterized by production and deposition of sodium urate crystals in various tissues. The consequence of this deposition in musculoskeletal system causes gouty arthritis often presented by acute recurrent attack and development of chronic tophi. The most important risk factor is hyperuricemia which means higher level of acid uric in blood. Gout or hyperuricemia alone represents significant independent risk factor of all-cause and cardiovascular morbidity and mortality. Many patients with hyperuricemia and gout have risk factors typical for metabolic syndrome or suffer from other diseases. Maintaining the acid uric serum levels below 360 µmol/l, dissolution of sodium urate deposits and prevention of their formation are crucial for successful treatment. In addition to the non-pharmacological approaches, medications as xanthine oxidase inhibitors or uricosuric agents are used for lowering serum uric acid levels in treatment of chronic hyperuricemia. The successful treatment may contribute to reduce cardiovascular risk in patients with hyperuricemia and gout.Key words: gout - hyperuricemia - cardiovascular risk - uric acid - metabolic syndrome - treatment.

摘要

痛风是一组异质性代谢紊乱疾病,其特征是尿酸钠晶体在各种组织中生成和沉积。这种沉积在肌肉骨骼系统中的后果会导致痛风性关节炎,常表现为急性反复发作以及慢性痛风石的形成。最重要的危险因素是高尿酸血症,即血液中尿酸水平升高。单纯的痛风或高尿酸血症是全因发病和心血管发病及死亡的重要独立危险因素。许多高尿酸血症和痛风患者具有代谢综合征的典型危险因素或患有其他疾病。将血清尿酸水平维持在360µmol/l以下、溶解尿酸钠沉积物并防止其形成对于成功治疗至关重要。除了非药物治疗方法外,黄嘌呤氧化酶抑制剂或促尿酸排泄剂等药物在慢性高尿酸血症治疗中用于降低血清尿酸水平。成功的治疗可能有助于降低高尿酸血症和痛风患者的心血管风险。关键词:痛风 - 高尿酸血症 - 心血管风险 - 尿酸 - 代谢综合征 - 治疗

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