Tausche A K
Medizinische Klinik III, Rheumatologie, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Fetscherstr. 74, 01309, Dresden, Deutschland.
Internist (Berl). 2021 May;62(5):513-525. doi: 10.1007/s00108-021-00987-1. Epub 2021 Mar 15.
Gout is the most common inflammatory arthritis in men with a rising incidence worldwide. It is a metabolic disease caused by hyperuricemia. Common causes of hyperuricemia, in addition to hereditary reduced renal excretion of urate, include purine over-nutrition, aging, comorbidities and associated medications, some of which increase serum urate levels. The first gout flare represents the signal for deposited urate crystals. If hyperuricemia remains untreated, crystal deposition proceeds and can cause recurrent gout flares, joint destruction and tophi. There is evidence that silent inflammation is ongoing even during asymptomatic stages. Gout patients often exhibit other metabolic, renal and cardiovascular co-morbidities and have higher (cardiovascular) mortality. Therefore, guidelines call for consequent urate lowering strategies to bring serum urate levels to a target at least below 360 µmol/l. The following article summarizes the recent state of knowledge regarding the diagnosis and therapy of gout.
痛风是男性中最常见的炎性关节炎，在全球范围内发病率呈上升趋势。它是一种由高尿酸血症引起的代谢性疾病。除遗传性尿酸肾排泄减少外，高尿酸血症的常见原因还包括嘌呤营养过剩、衰老、合并症及相关药物，其中一些会升高血清尿酸水平。首次痛风发作是尿酸盐结晶沉积的信号。如果高尿酸血症得不到治疗，结晶沉积会继续，并可导致痛风反复发作、关节破坏和痛风石。有证据表明，即使在无症状阶段也存在隐匿性炎症。痛风患者常伴有其他代谢、肾脏和心血管合并症，且（心血管）死亡率较高。因此，指南要求采取相应的降尿酸策略，将血清尿酸水平降至至少低于360µmol/L的目标值。以下文章总结了痛风诊断和治疗的最新知识状况。
