Dong Hong, Wang Li Min, Wang Zhi Qiang, Liu Yan Qing, Zhang Xiao Gang, Zhang Ming Ming, Liu Juan, Li Zhen Bin
Department of Rheumatology and Immunology, PLA Joint Logistic Support Force No.980 Hospital, Shijiazhuang 050082, China.
The Graduate School, Hebei Medical University, Shijiazhuang 050011, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2023 Oct 18;55(5):915-922. doi: 10.19723/j.issn.1671-167X.2023.05.021.
To observe the diurnal difference of acute gout attacks in men, and provide reference for accurate clinical prevention and treatment.
Using a single-center, cross-sectional study design, the patients diagnosed with gout in the outpatient department of Rheumatology and Immuno-logy of PLA Joint Logistic Support Force No.980 Hospital from October 2021 to April 2022 were selected. The information about the patient's current/last acute gout attacks (less than 2 weeks from visit), date and time of attacks, joint symptoms and signs, medication use, and relevant biochemical tests on the day of visit was recorded. The diurnal time difference of acute gout attacks in male patients was analyzed, and univariate comparison and multivariate Logistic regression analyses were conducted to compare the diurnal difference of acute gout attacks with clinical characteristics and biochemical indicators.
A total of 100 male gout patients were included, and 100 acute attacks were recorded. Diurnal distribution of acute gout attacks: morning (6:0011:59, 18, 18%), afternoon (12:0017:59, 11, 11%), the first half of the night (18:0023:59, 22, 22%), the second half of the night (0:0005:59, 49, 49%); During the day (included morning and afternoon, 29, 29%) and at night (included the first half of the night and the second half of the night, 71, 71%). The rate of acute gout attack was significantly higher at night than in the day (about 2.5 ∶1). No matter the first or recurrent gout, no matter the duration of the disease, the number of acute gout attacks had the difference of less in the day and more in the night. Serum urate (SU) level was higher in the patients with nocturnal attack than in those with daytime attack (=0.044). Comorbidities were significantly different in the day-night ratio of the number of acute gout attack (=0.028). Multiple Logistic regression analysis showed that SU level (=1.005, 95%: 1.001-1.009) and comorbidities (=3.812, 95%: 1.443-10.144) were the correlative factors of nocturnal acute gout attacks.
No matter the first or recurrent gout, no matter the duration of the disease, it has a diurnal variation characterized by multiple attacks at night, increased SU level and comorbidities are correlative factors for nocturnal acute attack of gout.
观察男性急性痛风发作的昼夜差异，为临床精准防治提供参考。
采用单中心横断面研究设计，选取2021年10月至2022年4月在解放军联勤保障部队第九八〇医院风湿免疫科门诊确诊为痛风的患者。记录患者当前/最近一次急性痛风发作（就诊前2周内）的信息、发作日期和时间、关节症状和体征、用药情况以及就诊当日的相关生化检查结果。分析男性患者急性痛风发作的昼夜时间差异，并进行单因素比较和多因素Logistic回归分析，比较急性痛风发作的昼夜差异与临床特征及生化指标的关系。
共纳入100例男性痛风患者，记录到100次急性发作。急性痛风发作的昼夜分布：上午（6:0011:59，18例，18%）、下午（12:0017:59，11例，11%）、前半夜（18:0023:59，22例，22%）、后半夜（0:0005:59，49例，49%）；白天（包括上午和下午，29例，29%）和夜间（包括前半夜和后半夜，71例，71%）。急性痛风发作率夜间显著高于白天（约为2.5∶1）。无论是初发还是复发痛风，无论病程长短，急性痛风发作次数均有白天少、夜间多的差异。夜间发作患者的血清尿酸（SU）水平高于白天发作患者（=0.044）。合并症在急性痛风发作次数的昼夜比例上有显著差异（=0.028）。多因素Logistic回归分析显示，SU水平（=1.005，95%：1.001-1.009）和合并症（=3.812，95%：1.443-10.144）是夜间急性痛风发作的相关因素。
无论是初发还是复发痛风，无论病程长短，均有昼夜变化，其特点为夜间发作次数多，SU水平升高和合并症是痛风夜间急性发作的相关因素。
