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痛风在临床容易误诊。本科近6年来共接诊痛风患者12例,其中有8例过去均误诊为其他疾病。误诊时间最长达10余年。8例均为男性,年龄58～72岁。血尿酸(UA)检查采用尿酸酶法,8例均在480～540μmol/L(正常值为150～420μmol/L)。本可将其误诊情况作分析讨论。一、误诊为风湿性关节炎4例 4例均表现为反复发作双下肢膝关节疼痛,不伴发烧。由于首诊为“风湿性关节炎”,复诊时大都采用抗炎、止痛对症治疗,症状缓解后即停药。到本科就诊查ASO<400U,UA均在520μmol/L以上。应用秋水仙硷,苯溴酮、别嘌呤醇等药物治疗,一般在5天内症状可控制,复查UA正常,随访1年未复发。
Gout is easily misdiagnosed in the clinic. In the past 6 years, a total of 12 cases of gout patients were admitted, of which 8 cases were misdiagnosed as other diseases in the past. Misdiagnosis of up to 10 years. 8 cases were male, aged 58 to 72 years. Serum uric acid (UA) test using uricase method, 8 cases were in 480 ~ 540μmol / L (normal value of 150 ~ 420μmol / L). This may be misdiagnosed for analysis and discussion. First, misdiagnosed as rheumatoid arthritis in 4 cases 4 cases showed repeated episodes of lower extremity knee pain, without fever. As the first diagnosis for “rheumatoid arthritis,” when the referral most of the anti-inflammatory, analgesic symptomatic treatment, withdrawal of symptoms after the withdrawal. To the undergraduate examination ASO <400U, UA are 520μmol / L or more. Application of colchicine, benzophenone, allopurinol and other drugs, usually within 5 days the symptoms can be controlled, review UA normal, followed up for 1 year without recurrence.