Department of General Surgery, the Affiliated Hospital of North Sichuan Medical College, Nanchong, 637000, P.R. China.
Institute of Hepatobiliary Pancreatic Intestinal Diseases, North Sichuan Medical College, Nanchong, 637000, P.R. China.
BMC Surg. 2024 Jun 14;24(1):186. doi: 10.1186/s12893-024-02472-6.
BACKGROUND/PURPOSE: Patients with gout are at risk for increased serum uric acid (SUA) levels and gout attacks in the short term after undergoing bariatric surgery, and the purpose of this study was to evaluate the benefits of short-term treatment with uric acid-lowering medication after bariatric surgery for the control of gout attacks and SUA levels in patients with gout.
71 patients who underwent SG from January 2020 to December 2022 were prospectively included. These patients were diagnosed with hyperuricemia before surgery and had a history of gout attacks. Patients were classified into a drug-treatment group (DTG, n = 32) and a non-drug-treatment group (NDTG, n = 39) according to whether they took uric acid-lowering medication after surgery. Changes in the number of gout attacks, body mass index (BMI), and SUA levels at 1 week, 1 month, 3 months, and 6 months after bariatric surgery were measured in both groups.
In the DTG, 22 patients (68.8%) experienced an increase in SUA within 1 week, 3 patients (9.4%) had an acute attack of gout within the first month, and no patients had a gout attack thereafter. In the NDTG, 35 patients (89.7%) experienced an increase in SUA within 1 week, 7 patients (17.9%) had an acute gout attack within the first month, and 4 patients (10.3%) experienced gout attacks between month 1 and month 3 postoperatively. Both groups were free of gout attacks between the 3rd and 6th postoperative month and showed a significant decrease in SUA and BMI by the sixth month.
In patients with gout, continued use of uric acid-lowering medication after bariatric surgery is beneficial in reducing the number of gout attacks and the risk of rising SUA.
背景/目的：接受减重手术后的短期内，痛风患者的血清尿酸（SUA）水平和痛风发作风险增加，本研究旨在评估减重手术后短期使用降尿酸药物治疗对控制痛风发作和痛风患者 SUA 水平的益处。
前瞻性纳入 2020 年 1 月至 2022 年 12 月接受袖状胃切除术（SG）的 71 例患者。这些患者在手术前被诊断为高尿酸血症，且有痛风发作史。根据术后是否服用降尿酸药物，将患者分为药物治疗组（DTG，n=32）和非药物治疗组（NDTG，n=39）。在两组中，测量了减重手术后 1 周、1 个月、3 个月和 6 个月时痛风发作次数、体重指数（BMI）和 SUA 水平的变化。
在 DTG 中，22 例（68.8%）患者在 1 周内 SUA 升高，3 例（9.4%）患者在第 1 个月内发生急性痛风发作，此后无患者发生痛风发作。在 NDTG 中，35 例（89.7%）患者在 1 周内 SUA 升高，7 例（17.9%）患者在第 1 个月内发生急性痛风发作，4 例（10.3%）患者在术后第 1 个月至第 3 个月期间发生痛风发作。两组患者在术后第 3 至 6 个月均无痛风发作，且 SUA 和 BMI 在第 6 个月时均显著下降。
在痛风患者中，减重手术后继续使用降尿酸药物有利于减少痛风发作次数和 SUA 升高的风险。
