关于痛风，被问得最多的9个问题
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">一位26岁的男性<span style="color: black;">病人</span>，大半夜吃完烧烤啤酒后，踝关节肿痛了3天到杭州师范大学<span style="color: black;">附庸</span>医院代谢病中心就诊，据他所说，平时<span style="color: black;">膳食</span>以外卖为主，每周吃两次烧烤，往常体检尿酸在400~500umol/L。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">这个<span style="color: black;">病人</span>有<span style="color: black;">非常多</span>疑问，都是平时在门诊上被问得最多的问题，今天就来一一解答给<span style="color: black;">大众</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q3.itc.cn/q_70/images03/20240726/a3c641dc3e504e4e9fea937779218211.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">1、<span style="color: black;">为何</span>这么<span style="color: black;">青年</span>就得了痛风？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">痛风早已<span style="color: black;">再也不</span>是老年男性高发病，随着生活水平的<span style="color: black;">加强</span>，三餐都吃大鱼大肉的<span style="color: black;">青年</span>人<span style="color: black;">作为</span>了主力军，八九岁的<span style="color: black;">孩儿</span>都有高尿酸、高血脂的了。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">2、<span style="color: black;">为何</span>喝酒后容易痛风<span style="color: black;">爆发</span>？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">饮酒<span style="color: black;">引起</span>尿酸水平<span style="color: black;">上升</span>是<span style="color: black;">由于</span>：酒精的代谢<span style="color: black;">增多</span>了三磷酸腺苷的消耗，<span style="color: black;">引起</span>尿酸产生<span style="color: black;">增多</span>；酒精<span style="color: black;">引起</span>血清乳酸<span style="color: black;">上升</span>，从而减少尿酸排泄；酒中含有嘌呤<span style="color: black;">引起</span>尿酸产生<span style="color: black;">增多</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">3、尿酸多高才会得痛风？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">这个问题因人而异，有血尿酸四五百就痛风<span style="color: black;">爆发</span>的，有血尿酸七八百还<span style="color: black;">无</span>症状的。但血尿酸<span style="color: black;">始终</span>维持在高水平<span style="color: black;">或</span>标准上限，患痛风的<span style="color: black;">危害</span>就会<span style="color: black;">增多</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">痛风<span style="color: black;">必定</span>是高尿酸血症<span style="color: black;">导致</span>的，血里尿酸水平<span style="color: black;">上升</span>，会以尿酸盐结晶形式在身体各个关节沉积，沉积到<span style="color: black;">必定</span>程度，会诱发痛风。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">痛风关节炎诱发<span style="color: black;">原因</span><span style="color: black;">包含</span>暴饮暴食、着凉、<span style="color: black;">疲劳</span>、剧烈运动、熬夜、喝水少、<span style="color: black;">海量</span>吃<span style="color: black;">果蔬</span>喝果汁等。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q7.itc.cn/q_70/images03/20240726/dc8639b01c9d4979bae6a7f05818935c.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">4、有多少高尿酸<span style="color: black;">病人</span>会发展成痛风？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">中国高尿酸血症的患病率达13.3%，痛风为1.1%。<span style="color: black;">亦</span><span style="color: black;">便是</span>说高尿酸血症不是<span style="color: black;">必定</span>会发展为痛风，但<span style="color: black;">长时间</span>高尿酸血症<span style="color: black;">出现</span>痛风的几率会<span style="color: black;">显著</span><span style="color: black;">增多</span>。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">因此</span><span style="color: black;">不可</span><span style="color: black;">无</span>症状就不治了，<span style="color: black;">亦</span><span style="color: black;">不可</span>症状缓解了，就停止降尿酸治疗。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">5、得了痛风是不是就好不了了？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">非常多</span><span style="color: black;">病人</span>害怕被诊断为痛风，误以为痛风一旦诊断会<span style="color: black;">伴同</span><span style="color: black;">一辈子</span>，<span style="color: black;">一生</span>就<span style="color: black;">不可</span>“摘帽子”了。其实痛风<span style="color: black;">是不是</span>会<span style="color: black;">作为</span>终身<span style="color: black;">疾患</span>取决于<span style="color: black;">是不是</span>治疗<span style="color: black;">即时</span>和彻底。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">治疗<span style="color: black;">即时</span>是说<span style="color: black;">发掘</span>高尿酸血症和/或痛风，<span style="color: black;">首要</span><span style="color: black;">能够</span><span style="color: black;">经过</span>改变生活方式<span style="color: black;">包含</span>低嘌呤<span style="color: black;">膳食</span>、多喝水，适当活动来降尿酸。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">必要时加上降尿酸<span style="color: black;">药品</span>联合治疗，达到关节里<span style="color: black;">无</span>尿酸盐结晶、血尿酸水平下降并保持正常范围，<span style="color: black;">此时</span><span style="color: black;">便是</span>正<span style="color: black;">一般人</span>了。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">6、<span style="color: black;">为何</span>会<span style="color: black;">显现</span>高尿酸？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">尿酸<span style="color: black;">源自</span><span style="color: black;">包含</span></span><strong style="color: blue;"><span style="color: black;">内源性和外源性</span></strong><span style="color: black;">，内源性<span style="color: black;">便是</span>人体的体细胞内的核酸分解为嘌呤、再进一步分解为尿酸。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">外源性即<span style="color: black;">每日</span>吃的<span style="color: black;">食品</span>中的嘌呤分解而来，<span style="color: black;">倘若</span>高嘌呤<span style="color: black;">食品</span>摄入<span style="color: black;">太多</span>，尿酸生成就会<span style="color: black;">增多</span>，日积月累就会<span style="color: black;">作为</span>高尿酸血症。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">高嘌呤<span style="color: black;">膳食</span>不仅限于海鲜、内脏，<span style="color: black;">各样</span>鸡鸭鱼肉、猪牛羊肉吃多了，都会<span style="color: black;">导致</span>尿酸生成<span style="color: black;">太多</span><span style="color: black;">引起</span>高尿酸血症。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">当然<span style="color: black;">短期</span>体重<span style="color: black;">增多</span>十几斤<span style="color: black;">乃至</span>几十斤,<span style="color: black;">必定</span>会<span style="color: black;">引起</span>内源性尿酸生成<span style="color: black;">增多</span>，<span style="color: black;">因此</span></span><strong style="color: blue;"><span style="color: black;"><span style="color: black;">减肥</span><span style="color: black;">亦</span>是降尿酸的<span style="color: black;">办法</span>之一</span></strong><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">7、<span style="color: black;">仅有</span>大脚趾关节<span style="color: black;">病痛</span>才是痛风吗？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">不是，大脚趾<span style="color: black;">病痛</span>是典型症状，事实上全身关节都<span style="color: black;">能够</span><span style="color: black;">出现</span>痛风，<span style="color: black;">包含</span>脚趾关节、踝关节、膝关节、手指关节、腕关节、肘关节等其至耳朵上都会有痛风石。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q3.itc.cn/q_70/images03/20240726/ceaf7fe260154bba97fc9906ed7bf467.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">8、降尿酸药能<span style="color: black;">不可</span>停？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">有些<span style="color: black;">病人</span>排斥吃药，认为吃上药就<span style="color: black;">不可</span>停，<span style="color: black;">或</span>担心<span style="color: black;">药品</span>的副<span style="color: black;">功效</span>。<span style="color: black;">实质</span>上大部分高尿酸、痛风是生活方式<span style="color: black;">导致</span>的，</span><strong style="color: blue;"><span style="color: black;">低嘌呤<span style="color: black;">膳食</span>、多喝水、<span style="color: black;">减肥</span>+短期<span style="color: black;">药品</span>治疗</span></strong><span style="color: black;"><span style="color: black;">就可</span>治愈。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">之后<span style="color: black;">再也不</span>大吃大喝就<span style="color: black;">无</span>高尿酸、痛风的<span style="color: black;">危害</span>了，<span style="color: black;">或</span>说改变生活方式<span style="color: black;">就可</span>预防高尿酸血症、痛风的<span style="color: black;">出现</span>。<span style="color: black;">因此</span><span style="color: black;">是不是</span>停药，决定于生活方式<span style="color: black;">是不是</span>彻底改变。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;">9、平时怎么喝水？多喝水能降尿酸吗？</strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">按照</span>国内外的指南<span style="color: black;">举荐</span>，在<span style="color: black;">无</span>肾脏病、心力衰竭的<span style="color: black;">状况</span>下，</span><strong style="color: blue;"><span style="color: black;">痛风<span style="color: black;">病人</span>和高尿酸血症<span style="color: black;">病人</span>的每日饮水量应该在2000～3000毫升。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;">人<span style="color: black;">身体</span>2/3的尿酸是<span style="color: black;">经过</span>肾脏排泄的，<span style="color: black;">因此</span>简单理解<span style="color: black;">便是</span>，多喝水就能多排尿，使尿液酸碱度（pH值）保持在6.3～6.8，有利于尿酸排泄，减少尿酸结晶形成。<span style="color: black;">同期</span>，多喝水还能减少痛风急性<span style="color: black;">爆发</span>的次数和<span style="color: black;">病痛</span>程度。<span style="color: black;">因此</span>，</span><strong style="color: blue;"><span style="color: black;">在痛风急性<span style="color: black;">爆发</span>期<span style="color: black;">亦</span><span style="color: black;">能够</span>适当多喝水。</span></strong></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">不外</span>要提醒<span style="color: black;">大众</span>，每日2000～3000毫升的水不是一次性喝完，而</span><strong style="color: blue;"><span style="color: black;">应该<span style="color: black;">掰开</span>多次饮用</span></strong><span style="color: black;">。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="https://q7.itc.cn/q_70/images03/20240726/42aa78d80ec343e7b603bb5e891bf8b5.gif" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><img src="//q3.itc.cn/q_70/images03/20240726/87297b7f4bfa46bd9bead4df3adcca47.jpeg" style="width: 50%; margin-bottom: 20px;"></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><strong style="color: blue;">寿 岚</strong></span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">专家</span>医师、医学硕士。现任浙江省中医药学会糖尿病分会委员，浙江省医学会心身医学分会委员，浙江省预防医学会<span style="color: black;">第1</span>届企业康促进专业委员会委员，浙江省<span style="color: black;">恢复</span>医学会健康管理专业委员会委员，浙江省中西医结合糖尿病专业委员会青年委员，浙江省医学会健康管理学分会青年委员，浙江省医师协会内分泌代谢科医师分会<span style="color: black;">第1</span>届青年委员，杭州市医学会健康管理分会秘书，杭州市科普专家，三级国家健康管理师。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><span style="color: black;"><span style="color: black;">善于</span>糖尿病及其并发症、甲状腺、高尿酸血症及痛风的诊治和内分泌疑难病的诊治；主攻多学科协作的诊治和管理糖尿病，主攻<span style="color: black;">肥壮</span>和脂肪肝的防治与管理；主攻高尿酸血症、痛风、骨质疏松的联合诊治和管理。</span></p>
<p style="font-size: 16px; color: black; line-height: 40px; text-align: left; margin-bottom: 15px;"><strong style="color: blue;"><span style="color: black;">高尿酸痛风/骨质疏松 联合诊治门诊时间</span></strong><span style="color: black;">：<strong style="color: blue;">每周一下午</strong></span></p>
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