| 摘要: |
| 目的 研究稳定期痛风合并上消化道出血患者使用质子泵抑制剂治疗后痛风急性发作情况、血尿酸及电解质改变情况,探讨痛风发作的可能原因及发生机制。方法 选择稳定期痛风合并上消化道出血患者20例作为观察组,以同期住院既往无痛风病史的高尿酸血症合并上消化道出血患者 20 例为对照组,分别收集两组患者质子使用泵抑制剂治疗前后尿 pH 值、治疗后血尿酸及电解质、及治疗后痛风发作情况,并进行统计学分析。结果 治疗期间观察组20例均出现痛风急性发作,使用PPI至临床出现痛风性关节炎急性发作时间在 1～8d,平均(3.95±1.79)d,表现为发热、关节不同程度红肿、疼痛及功能活动障碍,对照组均未出现上述临床症状。治疗后两组患者尿酸水平均较治疗前升高,与组内治疗前比较,差异均有统计学意义(P<0.05)。治疗后两组患者血清K+ 与Ca2+较治疗前降低,与组内治疗前比较,差异均具有统计学意义(P<0.05)；治疗后两组患者血清Cl- 较治疗前升高,与组内治疗前比较,差异均具有统计学意义(P<0.05)；治疗后两组患者Na+无明显变化,与组内治疗前比较,差异均无统计学意义(P>0.05)。结论 质子泵抑制剂可能在一定程度上对肾小管H+-K+-ATP酶产生抑制作用或损伤肾小管功能,进而促使痛风复发或加重。 |
| 关键词: 质子泵抑制剂 上消化道出血 痛风性关节炎 |
| DOI： |
| 分类号: |
| 基金项目:广西消化疾病临床医学研究中心建设项目(编号：桂科 AD17129027) |
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| Effect of proton pump inhibitors on acute gout attack in patients with upper gastrointestinal bleeding |
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李毓玲
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The People’s Hospital of Guangxi Zhuang Autonomous Region
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| Abstract: |
| Objective to study the acute attack of gout, changes of uric acid and electrolyte in patients with stable gout complicated with upper gastrointestinal bleeding after the treatment with proton pump inhibitors, and to explore the possible causes and mechanism of gout attack. Methods Twenty patients with stable gout and upper gastrointestinal hemorrhage were selected as the observation group. 20 patients with hyperuricemia and upper gastrointestinal hemorrhage who had no history of gout in the same period were used as the control group. Urinary pH before and after treatment, blood uric acid and electrolyte after treatment, and gout attack after treatment, and statistical analysis. Results During the treatment period, 20 patients in the observation group had acute episodes of gout. The acute onset time of gouty arthritis was 1 to 8 days, with an average of (3.95±1.79) days. It was characterized by fever, joint swelling and pain. Functional dysfunction, the above clinical symptoms did not appear in the control group. After treatment, the uric acid levels of the two groups were higher than those before treatment, and the differences were statistically significant (P<0.05). After treatment, serum K+ and Ca2+ were lower than those before treatment, and the difference was statistically significant (P<0.05). After treatment, serum Cl- was higher than that before treatment, and within the group. Before treatment, the differences were statistically significant (P<0.05). There was no significant change in Na+ between the two groups after treatment. There was no significant difference between the two groups (P>0.05). Conclusion Proton pump inhibitors may inhibit the renal tubular H+-K+-ATPase to some extent or impair the function of renal tubules, which may cause recurrence or aggravation of gout. |
| Key words: Proton pump inhibitors Upper gastrointestinal hemorrhage Acute gouty arthritis |
