Fam A G, Stein J, Rubenstein J
Department of Medicine, Sunnybrook Health Science Centre, University of Toronto, Ontario, Canada.
J Rheumatol. 1996 Apr;23(4):684-9.
To analyze the clinical features and identify factors associated with the development of gouty arthritis in nodal osteoarthritis (OA).
Thirty-two consecutive patients (21 women and 11 men, mean age 75.8 years) with both nodal OA and crystal proven acute gout and/or tophi of distal/proximal interphalangeal (DIP/PIP) joints were studied between 1986 and 1994.
Tophi of DIP and/or PIP joints were present in 29 (90%) patients; alone in 9 and together with acute DIP or PIP gouty arthritis in 20. Three patients had acute DIP or PIP gouty episodes but no digital tophi. Mean pretreatment serum urate was 614.9 +/- 163.2 (range 422-1088 mumol/l). Risk factors for gout included diuretic use (81%), renal failure (59%), hypertension (66%), alcoholism (22%), prophylactic low dose ASA (20%), and a positive family history (16%) of patients.
The coexistence of gouty arthritis in nodal OA is important to recognize and treat, particularly in elderly women with renal failure, hypertension, or cardiac failure who are receiving longterm diuretic therapy.
分析结节性骨关节炎（OA）中痛风性关节炎的临床特征，并确定其发病相关因素。
1986年至1994年间，对32例连续性患者（21例女性，11例男性，平均年龄75.8岁）进行研究，这些患者均患有结节性OA且经晶体证实存在远端/近端指间关节（DIP/PIP）的急性痛风和/或痛风石。
29例（90%）患者存在DIP和/或PIP关节痛风石；9例单独存在，20例合并急性DIP或PIP痛风性关节炎。3例患者有急性DIP或PIP痛风发作，但无手指痛风石。治疗前血清尿酸盐平均水平为614.9±163.2（范围422 - 1088μmol/L）。痛风的危险因素包括利尿剂使用（81%）、肾衰竭（59%）、高血压（66%）、酗酒（22%）、预防性低剂量阿司匹林使用（20%）以及患者家族史阳性（16%）。
结节性OA中痛风性关节炎的共存情况对于识别和治疗很重要，尤其对于正在接受长期利尿剂治疗的患有肾衰竭、高血压或心力衰竭的老年女性。
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