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痛风性关节炎的病理生理学与治疗;包括髋关节痛风性关节炎:文献综述

Pathophysiology and Treatment of Gout Arthritis; including Gout Arthritis of Hip Joint: A Literature Review.

作者信息

Cha Yonghan, Lee Jongwon, Choy Wonsik, Lee Jae Sun, Lee Hyun Hee, Chae Dong-Sik

机构信息

Department of Orthopedic Surgery, Daejeon Eulji Medical Center, Eulji University School of Medicine, Daejeon, Korea.

Advanced Therapy Center, Catholic Kwandong University International St. Mary's Hospital, College of Medicine, Catholic Kwandong University, Incheon, Korea.

出版信息

Hip Pelvis. 2024 Mar 1;36(1):1-11. doi: 10.5371/hp.2024.36.1.1.

Abstract

Gout is triggered by the accumulation of uric acid in the body, leading to hyperuricemia. Genetic, metabolic, and environmental factors can influence this condition. Excessive uric acid buildup results in the formation of monosodium urate (MSU) crystals, which precipitate in specific areas of the body, including the joints, where they can cause symptoms of gout. While the acute and chronic symptoms of gout have been well-documented, diagnosis of gout affecting the hip joint poses significant challenges. The global incidence of gout, the most prevalent form of inflammatory arthritis, is on the rise. Evaluation of the clinical signs, laboratory results, and imaging results is generally required for diagnosis of gout in cases where MSU crystals have not been detected. Hyperuricemia is considered a primary cause of arthritis symptoms, and comprehensive guidelines for treatment are available. Therefore, the choice of medication is straightforward, and moderate effectiveness of treatment has been demonstrated. Gout is a chronic disease, requiring lifelong uric acid-lowering medications, thus application of a treatment strategy based on the target blood uric acid concentration is necessary. Consequently, cases of gout will likely be observed more frequently by hip surgeons in clinical scenarios in the future. The objective of this review is to provide an overview of the pathophysiology of gout and subsequently examine recent advances in diagnostic methods and therapeutic agents based on an understanding of its underlying mechanisms. In addition, literature on gout-related issues affecting the hip joint, providing a useful reference for hip surgeons is examined.

摘要

痛风是由体内尿酸积累引发的,会导致高尿酸血症。遗传、代谢和环境因素都会影响这种病症。尿酸过度积累会导致单钠尿酸盐(MSU)晶体形成,这些晶体在身体的特定部位沉淀,包括关节,在那里它们会引发痛风症状。虽然痛风的急性和慢性症状已有充分记录,但诊断影响髋关节的痛风仍面临重大挑战。痛风是最常见的炎性关节炎形式,其全球发病率正在上升。在未检测到MSU晶体的情况下,痛风的诊断通常需要评估临床体征、实验室检查结果和影像学检查结果。高尿酸血症被认为是关节炎症状的主要原因,并且有全面的治疗指南。因此,药物选择很简单,而且治疗效果已得到证实。痛风是一种慢性病,需要终身服用降低尿酸的药物,因此有必要应用基于目标血尿酸浓度的治疗策略。因此,髋关节外科医生在未来的临床场景中可能会更频繁地遇到痛风病例。这篇综述的目的是概述痛风的病理生理学,随后基于对其潜在机制的理解,审视诊断方法和治疗药物的最新进展。此外,还研究了影响髋关节的痛风相关问题的文献,为髋关节外科医生提供有用的参考。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0fd8/10929543/22ac58d0f21c/hp-36-1-1-f1.jpg

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