超声对痛风肾诊断的临床研究及进展

张羽 杨静 董建玲 田岚 邹晋梅

【关键词】痛风是由于遗传性或获得性病因导致嘌呤代谢紊乱和(或)尿酸排泄减少所引起的一组疾病，是尿酸钠或尿酸盐结晶从超饱和的细胞外液沉积于组织所致的一种多种病变的临床综合征，痛风结晶可沉积于人体多种组织，如皮下脂肪、肌腱内，引起各部位的痛风石，可引起患者明显临床症状和造成功能障碍的是痛风性关节炎，是40岁以上男痛风性性关节炎患者最常见的病因之一，发病率超过1%，其临床特点为高尿酸血症、特征性反复发作的急性单关节炎、尿酸钠盐沉积形成痛风石、痛风性慢性关节炎和关节畸形，严重者可导致关节病变和骨关节活动障碍与畸形［1］，近年来随着生活水平的提高，痛风的患者呈逐渐增高的趋势［2］。痛风性关节炎是痛风最常见的首发症状，亦是最基本的类型［3］。痛风性关节炎的影像学检查，以往一般用X线平片，但不易显示早期病变。

【关键词】痛风性关节炎;超声诊断

【Abstract】gout is caused by genetic or get STDS because of purine metabolic disorders and (or) a group of diseases caused by uric acid excretion reduced, sodium is uric acid or urate crystals from super saturation of extracellular fluid of the deposit on the organization caused by a variety of pathological changes of clinical syndrome, gout crystalline can be deposited on various body tissues, such as subcutaneous fat, tendons, the different parts of gout stone, can cause obvious clinical symptoms and cause dysfunction of gouty arthritis, is over 40 male patients with gouty arthritis, one of the most common etiology incidence by more than 1% of its clinical features is characteristic of high uric acid hematic disease, recurrent acute arthritis, uric acid sodium salt deposit formation stone of gout, gouty chronic arthritis and joint deformities, severe cases can lead to joint disease and joint activities with deformity ［1］, in recent years, with the improvement of living standards, gout patients showed a trend of increase gradually ［2］. Gouty arthritis, gout, the most common symptoms start, also is the most basic types ［3］. The imaging examination of gouty arthritis, ever with X-ray plain film, but not easy to show early lesions.

【key words 】gouty arthritis. Ultrasonic diagnosis

【中圖分类号】R722.12 【文献标识码】B【文章编号】1004-4949(2014)07-0595-01

1导致痛风的病因

高尿酸血症是导致痛风性关节炎的重要因素，尿酸的产生取决于细胞中的嘌呤摄入。病因有原发性和继发性两类，原发性与家族遗传有关，继发者则常因其他疾病引起，如血液病、肾病、肿瘤等。老年“痛风”患者的常见病因常有甲状腺功能减退、肾脏功能不全。近年来由于抗癌治疗的开展，继发性痛风有增加趋势。

2痛风性关节炎的病理改变、临床表现及超声表现