“Shen Du Jun, what should be checked for gout? Can it be cured?”
Shen Du Jun, a warm-hearted man in the medical science community, this is what Presenting super practical dry goods for you – “Topics on Gout Investigation and Treatment”
< span>Examination
Physical examination
The doctor grasps the relevant information by asking Information, such as jointis pain, how much pain, and duration strong> etc.
The joints should be observed for the presence of swelling, deformity, limited mobility, etc. Preliminary diagnosis of gout.
serum uric acid determination
Through blood draw, it was detectedmale blood uric acid levelmore than420μmol /Lorwomen’s blood uric acid levelgreater than 357μmol/L, indicating possible hyperuricemia.
Combining symptoms and physical examination, gout can basically be diagnosed.
Urine uric acid p>
After the diagnosis of hyperuricemia, urine uric acid measurement can be used to find outcause, and determine the severity of gout Clinical classification.
Urine uric acid is measured by collecting 24 hours of total urine, < /span>mixing, and then extract samples for testing.
measureduric acid concentration, multiplied by Total Urine, which can calculate the amount of uric acid excreted in urine in a single dayTotal uric acid .
The total amount of uric acid excreted in 24 hours, if it is low, it means too little excretion of uric acid, there may be a problem with ejection. If it is too high, it may be too much uric acid production, production process< /strong>Something went wrong.
arthrocentesis p>
Arthrocentesis is the diagnosis of goutgold standard, by puncture, to obtainsynovial fluid in the joint cavity, if found in the synovial fluid under a microscopeurate crystals strong>, that’s gout.
X-rays
goutearly Often no obvious X-ray findings.
As the disease progresses, tophi may be observed around the affected jointsDeposition, and there is bone destruction at the joint edge.
ultrasound of joints
Joint effusion is observed under ultrasound, if there is a heterogeneous fine dot echo, similar to cloudy , called “Blizzard Sign“.
Observe the surface of the articular cartilage under ultrasound, if there is double-layer parallel hyperechoic , known as “Dual Track Sign“
“Blizzard Sign” and “Dual Track Sign” ” all indicate the presence of urate crystals deposition, which is the most characteristic ultrasound manifestation of gout.
Therapy
Anti-inflammatory and analgesic treatment
goutacute attack , multi-drug anti-inflammatory and analgesictreatment to relieve joint pain.
Commonly used drugs includenon-steroidal anti-inflammatory drugs, colchicine and < /span>Glucocorticoids.
NSAIDs
Gout attacks are actually in the joints span>Urate crystalsInflammation.
Prostaglandins are very important inflammatory mediators.
It candilate blood vessels and call more < strong>Immune cellsgo to the battlefield to kill the enemy, further aggravating the inflammation.
NSAIDs can reduce the synthesis of prostaglandins, control joint inflammation and relieve joint pain strong>.
representative drugs includedomethacin, diclofenac, etoricoxib, etc.
colchicine
Colchicine not only interferes withimmune cell function, but also inhibits< span>immune cell activity, thereby reducingimmune response, reaching< strong>Anti-inflammatory and analgesicTherapeutic purposes.
Glucocorticoids
Gout attacks are a type of joint Inflammation.
Glucocorticoids can quietimmune cells and keep inflammation under control.
representative drugs areprednisoneand< span>Methylprednisolone, etc.
Uric acid-lowering therapy
Controlling the level of uric acid in the blood within a reasonable range can reduce gout attacks.
inhibits uric acid production
purines Under the mixing of xanthine oxidase, it can be transformed into uric acid after a series of reactions.
If the activity of xanthine oxidaseis inhibited,< strong>Uric acidThe production will naturally drop.
representative drugs includealopurinol, febuxostat, etc.
Promote uric acid excretion
Drugs that promote uric acid excretion can act onrenal tubules, inhibiting renal tubular excretion of uric acid< strong>Reabsorption.
moreuric acidwith Urineexcreted, doesn’t the uric acid level in the blood drop?
representative drugs includeprobenecid, benzbromarone, etc.
Surgery
TophiCommonAuricles, fingertips, joints< span> and other parts.
If tophi affectsjointfunction, compression nerves, blood vesselsand other tissues or causerupture, infection, need to be removed Tophi.
You still need to pay attention after surgerylow-purine diet to control the blood uric acid level.
“Shen Read Jun, you have made gout so clear that it is like walking Medical book! Please pay my respects to my little brother!”
What nonsense are you talking about! Deep reading Jun has completed popular science, so let’s leave, see you in the next topic!
Follow “Deep Reading Video”, remember to like and forward! Chimi!