Lally E V, Ho G, Kaplan S R
Arch Intern Med. 1986 Nov;146(11):2221-5.
We reviewed crystal-proved gouty arthritis in 23 women. Twenty-one (91%) developed gout after menopause onset. Tophaceous gout occurred in six (26%), polyarticular involvement in 13 (57%); 70% manifested an underlying arthropathy, usually osteoarthritis. We studied 75 men with crystal-proved gout for comparison. Women developed gout significantly later compared with men, more often were receiving diuretics before gout onset, and more frequently manifested renal insufficiency and monoarticular involvement. These differences were significant when controlled for the women's later age at onset. Significantly more men than women had alcoholism and an identifiable precipitating event for acute attacks. There were no significant differences in race, age, family history of gout, disease duration, hypertension, distribution of joint involvement, tophi, or mean serum urate concentration. Gout in women is overwhelmingly postmenopausal, apparently associated with diuretic therapy and renal insufficiency independent of the effects of age. Articular characteristics in men and women are remarkably similar.
我们回顾了23例经晶体证实的女性痛风性关节炎患者。其中21例（91%）在绝经后发病。有6例（26%）出现痛风石性痛风，13例（57%）有多关节受累；70%有潜在关节病，通常为骨关节炎。我们研究了75例经晶体证实的男性痛风患者作为对照。与男性相比，女性痛风发病明显较晚，痛风发作前更常服用利尿剂，且更频繁地出现肾功能不全和单关节受累。在控制了女性较晚的发病年龄后，这些差异仍然显著。男性患酒精中毒和有明确急性发作诱发事件的比例明显高于女性。在种族、年龄、痛风家族史、病程、高血压、关节受累分布、痛风石或平均血清尿酸浓度方面，男女之间无显著差异。女性痛风绝大多数发生在绝经后，显然与利尿剂治疗和肾功能不全有关，与年龄的影响无关。男性和女性的关节特征非常相似。
