原发性痛风误诊误治60例临床分析

摘要

Objective To investigate the incidence and clinical characteristics of patients with primary gout disease.Methods Collecting shuguang hospital affiliated to Shanghai university of TCM in January 2014 to June 2016 had the disease the clinical data of 60 cases were analyzed retrospectively.Results 60 cases have no specificity, depending on the frequency performance for joint swelling pain, limited activity, redness, skin temperature, though lower limb swelling in the lesion site.Groups successively in the outer court and our hospital diagnosed as: 18 cases (30.0%) with rheumatoid arthritis and osteoarthritis, 14 cases (23.3%) with rheumatoid arthritis, 6 cases of acute suppurative arthritis (10.0%), erysipelas in 2 cases (3.3%), 1 case with buerger's disease (1.7%), 1 case (1.7%) of the kidney stones.After diagnosis to reduce uric acid, anti-inflammatory and analgesic treatment, prognosis and the course of the disease have a certain correlation.Conclusion Clinicians should be familiar with the early onset of primary gout specificity and Suggestions combined with clinical symptoms and biochemical identification with similar disease, in order to improve the early diagnostic rate, win early treatment for patients with time, and improve the prognosis.%目的 探讨原发性痛风的发病及临床特点.方法 回顾性分析上海中医药大学附属曙光医院2014年1月-2016年6月误诊误治的60例原发性痛风患者临床资料.结果 60例表现为关节肿痛、活动受限、皮色发红、皮温升高,下肢病变部位肿胀,先后在外院及本院误诊为:类风湿性关节炎及骨关节炎各18例(30.0%),风湿性关节炎14例(23.3%),急性化脓性关节炎6例(10.0%),丹毒2例(3.3%),血栓闭塞性脉管炎及肾结石各1例(1.7%).按照误诊疾病予对症治疗症状反复.根据血尿酸升高并结合临床特征确诊原发性痛风,误诊时间2周~4个月.确诊后予降尿酸、抗炎及镇痛等治疗,预后不良.结论 原发性痛风早期临床表现无特异性,易误诊;结合临床表现,及时查血尿酸和行秋水仙碱试验性治疗可明确诊断.