The Department of Endocrinology and Metabolism, The Affiliated Hospital of Qingdao University, 16 Jiangsu Rd, Qingdao, 266003, China.
Qingdao University, 308 Ningxia Road, Qingdao, Shandong, China.
Clin Rheumatol. 2018 May;37(5):1359-1365. doi: 10.1007/s10067-017-3969-y. Epub 2018 Jan 22.
The objective of this study is to analyze clinical characteristics associated with the formation of subcutaneous tophi among Chinese gout patients. It was a retrospective outpatient cohort study. Five thousand six hundred ninety-three gout patients treated at the Affiliated Hospital of Qingdao University from March 2011 to February 2016 were included and divided into the tophus group and non-tophus group according to the presence of megascopic tophus. Relevant clinical information and biochemical parameters were analyzed to identify potential risk factors for the incidence of subcutaneous tophi. There are significant difference (P < 0.05) between the tophus and non-tophus groups in gender, family history, exercise, incidence of obesity, hypertension, renal dysfunction, kidney stone, coronary heart disease, and upper limb joint involvement. Between the two groups, significant difference (P < 0.01) was detected in the onset age (43.80 ± 13.82 years vs. 45.40 ± 13.77 years), duration of disease (10.28 ± 7.54 years vs. 5.11 ± 6.06 years), number of joint involved (3.11 ± 2.15 vs. 1.81 ± 1.35), systolic pressure (138.53 ± 19.46 mmHg vs. 133.87 ± 17.93 mmHg), diastolic pressure (89.55 ± 12.73 mmHg vs. 87.48 ± 11.77 mmHg), serum uric acid (487.15 ± 120.13 μmol/L vs. 458.89 ± 119.04 μmol/L), creatinine (93.87 ± 54.19 μmol/L vs. 85.51 ± 37.71 μmol/L), and creatinine clearance rate (Ccr) (93.05 ± 48.7 mL/min vs. 106.61 ± 51.76 mL/min). Logistic regression analysis suggests that duration of disease, number of joints involved, involvement of upper limb joints, kidney stones, diastolic pressure, and serum uric acid are associated with the subcutaneous tophi formation, while exercise and obesity are protective factors. The present study has identified several clinical parameters (such as duration of disease, involvement of upper limb joints, involved joints, kidney stone, hypertension) as risk factors for the incidence of subcutaneous tophi, which provides insights into the treatment and prevention of tophus.
本研究旨在分析与中国痛风患者皮下痛风石形成相关的临床特征。这是一项回顾性门诊队列研究。纳入 2011 年 3 月至 2016 年 2 月期间在青岛大学附属医院接受治疗的 5693 例痛风患者，并根据是否存在肉眼可见的痛风石将其分为痛风石组和非痛风石组。分析相关临床信息和生化参数，以确定皮下痛风石发病的潜在危险因素。痛风石组和非痛风石组在性别、家族史、运动、肥胖发生率、高血压、肾功能不全、肾结石、冠心病和上肢关节受累方面存在显著差异（P<0.05）。两组间发病年龄（43.80±13.82 岁 vs. 45.40±13.77 岁）、病程（10.28±7.54 年 vs. 5.11±6.06 年）、受累关节数（3.11±2.15 个 vs. 1.81±1.35 个）、收缩压（138.53±19.46mmHg vs. 133.87±17.93mmHg）、舒张压（89.55±12.73mmHg vs. 87.48±11.77mmHg）、血尿酸（487.15±120.13μmol/L vs. 458.89±119.04μmol/L）、肌酐（93.87±54.19μmol/L vs. 85.51±37.71μmol/L）和肌酐清除率（Ccr）（93.05±48.7mL/min vs. 106.61±51.76mL/min）存在显著差异（P<0.01）。Logistic 回归分析提示病程、受累关节数、上肢关节受累、肾结石、舒张压和血尿酸与皮下痛风石形成有关，而运动和肥胖是保护因素。本研究确定了一些临床参数（如病程、上肢关节受累、受累关节、肾结石、高血压）是皮下痛风石发病的危险因素，为痛风石的治疗和预防提供了思路。
