Rozenberg S, Bourgeois P
Service de rhumatologie du Pr Bourgeois, hôpital de la Pitié, Paris.
Rev Prat. 1994 Jan 15;44(2):178-82.
Gout is a disease caused by deposits of sodium urate crystals in tissues. This disease, already known of Hippocrates, is now due to new causes, notably iatrogenic, and has new clinical forms. The typical initial attack usually occurs in men in their fifties and affects the big toe; in the absence of treatment it evolves towards chronic tophaceous gout. When gout occurs in subjects younger than 30 years, these must be investigated for enzyme deficit which is usually partial. The incidence of gout in women is ever increasing, being encouraged by treatments with diuretic drugs. Gout is often atypical, affecting predominantly the hands and with rapid development of tophus. In transplanted patients other drugs, such as cyclosporin, may induce an early, polyarticular and tophaceous gout. Alcohol is a facilitating factor of hyperuricaemia. Disturbances of metabolism, such as hyperlipidaemia, obesity or arterial hypertension, are often associated with hyperuricaemia. With an early and well-conducted treatment the passage to chronicity and the occurrence of complications can be avoided.
痛风是一种由尿酸钠晶体在组织中沉积引起的疾病。这种疾病希波克拉底就已熟知，如今病因有了新变化，尤其是医源性病因，且出现了新的临床形式。典型的首次发作通常发生在五十多岁的男性身上，累及大脚趾；若不治疗，会发展为慢性痛风石性痛风。痛风发生在30岁以下的患者时，必须检查是否存在酶缺乏，这种缺乏通常是部分性的。女性痛风的发病率不断上升，利尿剂治疗对此有推动作用。痛风常不典型，主要累及手部，痛风石发展迅速。在移植患者中，其他药物如环孢素可能诱发早期、多关节性和痛风石性痛风。酒精是高尿酸血症的促发因素。代谢紊乱，如高脂血症、肥胖或动脉高血压，常与高尿酸血症相关。早期且规范的治疗可避免病情发展为慢性并预防并发症的发生。
