-
Categories
-
Pharmaceutical Intermediates
-
Active Pharmaceutical Ingredients
-
Food Additives
- Industrial Coatings
- Agrochemicals
- Dyes and Pigments
- Surfactant
- Flavors and Fragrances
- Chemical Reagents
- Catalyst and Auxiliary
- Natural Products
- Inorganic Chemistry
-
Organic Chemistry
-
Biochemical Engineering
- Analytical Chemistry
- Cosmetic Ingredient
-
Pharmaceutical Intermediates
Promotion
ECHEMI Mall
Wholesale
Weekly Price
Exhibition
News
-
Trade Service
Recently, I met such a patient in an outpatient clinic.
The 27-year-old Mr.
Wang had a physical examination for two consecutive years and found that his blood uric acid level fluctuated between 450-520umol/L (normal ≤420umol/L).
He was in good health before and had no history of acute attacks of joint swelling and pain.
Mr.
Wang was very anxious, worried whether he had gout, and asked whether he should use uric acid-lowering drugs for treatment.
Like Mr.
Wang, there are not a few patients with high blood uric acid found in the physical examination.
Today, let’s talk about the topic of high uric acid and gout.
First of all, a clear definition is needed: hyperuricemia ≠ gout hyperuric acid or hyperuric acid hyperuricemia is called hyperuricemia, which refers to the normal purine diet and the fasting blood uric acid level> 420umol/L twice on different days.
Gout is a crystal-associated arthropathy caused by the deposition of urate in the joints.
It is directly related to hyperuricemia caused by purine metabolism disorder and/or decreased uric acid excretion, and belongs to the category of metabolic rheumatism.
In theory, hyperuricemia is the pathophysiological basis of gout, but when the body only has elevated blood uric acid without joint swelling and pain and other clinical manifestations, we call it asymptomatic hyperuricemia, and it cannot be judged as gout.
So hyperuricemia ≠ gout.
In recent years, with the continuous improvement of people's living standards, the prevalence of asymptomatic hyperuricemia has been increasing year by year.
According to statistics, the prevalence of male hyperuricemia in my country is 9.
2%-26.
2%.
The prevalence increases with age.
Generally speaking, urban areas are higher than rural areas, and coastal areas are higher than inland areas.
The long-term increase of blood uric acid can lead to precipitation and deposition of urate crystals in joints, surrounding soft tissues, renal tubules and blood vessels, and over time cause acute and chronic inflammatory damage such as articular cartilage, bone, kidney and vascular intima.
Does hyperuricemia need to be treated with uric acid lowering drugs? Let’s take a look at the guidelines proposed by the American Academy of Rheumatology in 2020: for asymptomatic hyperuricemia patients, no matter how high the blood uric acid level is, regardless of whether they are combined with cardiovascular disease, chronic kidney disease, kidney stones, etc.
Uric acid-lowering drugs are not recommended for initiation of uric acid-lowering therapy.
The domestic treatment of asymptomatic hyperuricemia is different from whether to initiate uric acid-lowering drug treatment.
The "Guidelines for the Diagnosis and Treatment of Hyperuricemia and Gout in China (2019)" published in early 2020 pointed out that patients with hyperuricemia need comprehensive and comprehensive treatment.
Long-term full-process management, according to the blood uric acid level and combined clinical symptoms/signs, determine the timing of drug initiation, and formulate corresponding treatment goals, and carry out hierarchical management.
1.
Patient management is the basis.
Knowledge of hyperuricemia should be understood and individualized life>
If there are comorbidities, it is necessary to work with a specialist to formulate a treatment plan for the comorbidities and avoid the use of drugs that affect the metabolism of uric acid.
2.
Non-drug treatment is the key.
Promote a balanced diet, with low-purine diet as the mainstay.
Drink plenty of water to maintain a daily urine output of 2000-3000ml.
Drink milk and dairy products (especially skimmed milk and low-calorie yogurt).
Avoid cola, orange juice, apple juice and other fructose drinks or sugary soft drinks.
Regular exercise to reduce weight can effectively reduce blood uric acid levels.
3.
Drug therapy is supplementary.
For patients with hyperuricemia, non-pharmacological interventions are not effective.
Drug therapy can be considered as appropriate.
Especially for patients with long-term blood uric acid levels> 480 umol/L, combined with metabolic syndrome, cardiovascular disease, chronic kidney disease, and kidney stones, multidisciplinary cooperation should be made to formulate a reasonable uric acid-lowering treatment plan.
Finally, let’s take a look at Mr.
Wang’s situation.
Is it necessary to use uric acid-lowering drugs for treatment? According to the medical history, given that Mr.
Wang has not paid attention to his diet in his usual life, and Mr.
Wang currently has no symptoms or comorbidities, it is recommended that Mr.
Wang first intervene in accordance with the above-mentioned patient management and non-drug treatment methods.
The start is not recommended for the time being Uric acid-lowering drug treatment. Source: Doctor Hu
The 27-year-old Mr.
Wang had a physical examination for two consecutive years and found that his blood uric acid level fluctuated between 450-520umol/L (normal ≤420umol/L).
He was in good health before and had no history of acute attacks of joint swelling and pain.
Mr.
Wang was very anxious, worried whether he had gout, and asked whether he should use uric acid-lowering drugs for treatment.
Like Mr.
Wang, there are not a few patients with high blood uric acid found in the physical examination.
Today, let’s talk about the topic of high uric acid and gout.
First of all, a clear definition is needed: hyperuricemia ≠ gout hyperuric acid or hyperuric acid hyperuricemia is called hyperuricemia, which refers to the normal purine diet and the fasting blood uric acid level> 420umol/L twice on different days.
Gout is a crystal-associated arthropathy caused by the deposition of urate in the joints.
It is directly related to hyperuricemia caused by purine metabolism disorder and/or decreased uric acid excretion, and belongs to the category of metabolic rheumatism.
In theory, hyperuricemia is the pathophysiological basis of gout, but when the body only has elevated blood uric acid without joint swelling and pain and other clinical manifestations, we call it asymptomatic hyperuricemia, and it cannot be judged as gout.
So hyperuricemia ≠ gout.
In recent years, with the continuous improvement of people's living standards, the prevalence of asymptomatic hyperuricemia has been increasing year by year.
According to statistics, the prevalence of male hyperuricemia in my country is 9.
2%-26.
2%.
The prevalence increases with age.
Generally speaking, urban areas are higher than rural areas, and coastal areas are higher than inland areas.
The long-term increase of blood uric acid can lead to precipitation and deposition of urate crystals in joints, surrounding soft tissues, renal tubules and blood vessels, and over time cause acute and chronic inflammatory damage such as articular cartilage, bone, kidney and vascular intima.
Does hyperuricemia need to be treated with uric acid lowering drugs? Let’s take a look at the guidelines proposed by the American Academy of Rheumatology in 2020: for asymptomatic hyperuricemia patients, no matter how high the blood uric acid level is, regardless of whether they are combined with cardiovascular disease, chronic kidney disease, kidney stones, etc.
Uric acid-lowering drugs are not recommended for initiation of uric acid-lowering therapy.
The domestic treatment of asymptomatic hyperuricemia is different from whether to initiate uric acid-lowering drug treatment.
The "Guidelines for the Diagnosis and Treatment of Hyperuricemia and Gout in China (2019)" published in early 2020 pointed out that patients with hyperuricemia need comprehensive and comprehensive treatment.
Long-term full-process management, according to the blood uric acid level and combined clinical symptoms/signs, determine the timing of drug initiation, and formulate corresponding treatment goals, and carry out hierarchical management.
1.
Patient management is the basis.
Knowledge of hyperuricemia should be understood and individualized life>
If there are comorbidities, it is necessary to work with a specialist to formulate a treatment plan for the comorbidities and avoid the use of drugs that affect the metabolism of uric acid.
2.
Non-drug treatment is the key.
Promote a balanced diet, with low-purine diet as the mainstay.
Drink plenty of water to maintain a daily urine output of 2000-3000ml.
Drink milk and dairy products (especially skimmed milk and low-calorie yogurt).
Avoid cola, orange juice, apple juice and other fructose drinks or sugary soft drinks.
Regular exercise to reduce weight can effectively reduce blood uric acid levels.
3.
Drug therapy is supplementary.
For patients with hyperuricemia, non-pharmacological interventions are not effective.
Drug therapy can be considered as appropriate.
Especially for patients with long-term blood uric acid levels> 480 umol/L, combined with metabolic syndrome, cardiovascular disease, chronic kidney disease, and kidney stones, multidisciplinary cooperation should be made to formulate a reasonable uric acid-lowering treatment plan.
Finally, let’s take a look at Mr.
Wang’s situation.
Is it necessary to use uric acid-lowering drugs for treatment? According to the medical history, given that Mr.
Wang has not paid attention to his diet in his usual life, and Mr.
Wang currently has no symptoms or comorbidities, it is recommended that Mr.
Wang first intervene in accordance with the above-mentioned patient management and non-drug treatment methods.
The start is not recommended for the time being Uric acid-lowering drug treatment. Source: Doctor Hu
