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缺血性心脏病、高血压和肾衰是痛风复发的危险因素

上一篇 / 下一篇 2012-02-04 10:21:14 / 个人分类：痛风专题

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刘蕊

摘要(英国): 目的：迄今为止，没有充分的数据归纳痛风患者痛风发病的特点。本研究的目的为探讨痛风的发作频率及合并特殊疾病导致痛风发作的危险因素。

方法：队列研究的数据来自一个英国的资料库（健康促进网络），包括了2000年至2007年年龄在20-89岁的有痛风发作的注册患者。

结果：该研究纳入了23857例患者，总发病率为2.68每1000人.年(95% CI 2.65, 2.72)。在随访中（平均3.8年）至少有一次痛风复发的患者占36.9%(n=8806)。缺血性心脏病[hazard ratio (HR) 1.12 (95% CI 1.06, 1.19)]、高血压[HR 1.15 (95% CI 1.10, 1.20)]和肾衰[HR 1.33 (95% CI 1.20, 1.48)]病史分别是第一次痛风复发是独立危险因素。在初次确诊痛风后应用别嘌醇治疗痛风复发的风险降低[HR 0.80 (95% CI 0.75, 0.85)]。

结论：痛风患者出现痛风复发是很常见的。潜在的心肌代谢性疾病是痛风复发的独立危险因素，而且增加了治疗痛风复发的难度。

附原文: Abstract OBJECTIVE: So far, few data are available to characterize the flare history of patients with gout. The objective of this study was to describe the frequency and risk factors of gout flares with special consideration of the comorbidity.METHODS: A cohort study was conducted in a U.K. general practice database (The Health Improvement Network) including all patients aged 20-89 years diagnosed with incident gout between the years 2000 and 2007.RESULTS: In this study, 23 857 incident gout patients (mean age 61.9 years) were included, overall incidence rate was 2.68 (95% CI 2.65, 2.72) per 1000 person-years. The proportion of patients with at least one flare during the follow-up period (mean 3.8 years) was 36.9% (n=8806). A history of ischaemic heart disease [hazard ratio (HR) 1.12 (95% CI 1.06, 1.19)], hypertension [HR 1.15 (95% CI 1.10, 1.20)] and renal failure [HR 1.33 (95% CI 1.20, 1.48)] were independently associated with a higher risk of a first gout flare. Use of allopurinol at initial gout diagnosis was associated with a lower risk [HR 0.80 (95% CI 0.75, 0.85)].CONCLUSIONS: Gout flares are relatively common among patients with gout. Some of the underlying cardiometabolic comorbid conditions are themselves independent risk factors for flares, which further contribute to the complexity of treatment of gout flares.

引自: Rothenbacher D, Primatesta P, Ferreira A, Cea-Soriano L, Rodríguez LA. Frequency and risk factors of gout flares in a large population-based cohort of incident gout. Rheumatology (Oxford). 2011 May;50(5):973-81. Epub 2011 Jan 12.