Does excess uric acid lead to gout? Does normal uric acid prevent gout? the doctor tells you

01

Plus what is the normal value of uric acid, this is the "three questions of the soul" about blood uric acid!

Many of us know the normal value of uric acid, that is, it should not exceed 420μmol/L (7mg/dl), but it is very complicated to cause gout, because some people have very high uric acid and do not develop gout, while others The patient, whose blood uric acid is normal, has also developed gout. Today we will talk about this problem.

02

The pathological basis of gout attack is hyperuricemia!

Under normal circumstances, if the result of two consecutive, non-same day, fasting measurements of the same patient exceeds 420, it can be diagnosed as hyperuricemia. 3~5 days time measurement, this value will be more accurate.

If our blood uric acid exceeds the normal value, then these excess blood uric acid is in a supersaturated state, and it is possible to form urate crystals, which are the culprit of gout attacks, and they can be deposited in most of the body Sites, including the ear, including the bone marrow can be deposited. Small amounts of urate deposits may not cause a particular problem, but these deposited urate crystals will become more and more numerous, and when they become powerful enough, they may start a riot, causing the patient's death. A gout attack.

But it does not mean that with hyperuricemia, gout will definitely develop. In general, the higher the uric acid, the greater the possibility of gout. The longer the uric acid exceeds the standard, the greater the possibility of gout. Studies have shown that if the blood uric acid exceeds 600, 70.2 out of every 1,000 people will have the possibility of developing gout. With the accumulation of time, if the uric acid continues to exceed 600, the possibility of developing gout will reach 30.5%.

So is it because the blood uric acid exceeds the standard, and there is no gout, everything can be fine, and the blood uric acid is ignored? Of course not. Current research has proven that prolonged exposure to high uric acid will cause many other physical harms to patients. For example, every 60% increase in our blood uric acid will increase the risk of hypertension by 1.4 times. It will increase the risk of diabetes by 17%, and will lead to a 12% increase in mortality in patients who already have coronary heart disease.

In addition, it has also been found that many patients are in the state of subclinical gout, that is to say, although the patients have not experienced gout, due to the long-term increase of blood uric acid, the joints of the patients have been damaged. Bone was damaged, but the patient was asymptomatic. Long-term higher than normal serum uric acid can also increase the possibility of kidney stones.

Overall, even if a patient with hyperuricemia does not develop gout, long-term hyperuricemia will cause harm to the body, and it is absolutely necessary to control uric acid.

03

Will gout develop in gout patients with normal uric acid control?

If the uric acid of a gout patient is well controlled, the probability of gout attack will be significantly reduced. When the blood uric acid of a gout patient drops below 360, the chance of gout recurrence will be less than 14%. But please note that this is not 100% non-recurrence, because gout patients still have urate crystals deposited in their bodies, and sometimes it may not be due to dietary factors that trigger the onset of gout, it may be a cold, a trauma or a stay up late , Poor rest may also lead to gout attacks.

In addition, there is another possibility that the uric acid has been normal, but gout will recur repeatedly. This phenomenon is very easy to occur in the early stage of uric acid control in gout patients. The main reason is that there are a large number of urate crystals in the patient's body. During the period of reducing uric acid through drugs, the concentration of uric acid in the blood will drop significantly, so the body will By default, if the blood uric acid becomes less, it will mobilize these uric acid crystals to dissolve into the blood, then it is easy to cause the attack of gout. Onset, the pain tends to be slightly less.

In response to this situation, the minimum dose of uric acid should be used to control uric acid in the early stage of using drugs to reduce uric acid, and the uric acid should be gradually reduced to normal without being too hasty. Narcissine to help control possible inflammatory reactions.

04

Hyperuricemia and gout, what kind of situation should be treated with uric acid lowering?

●If the patient's blood uric acid is relatively high, but there is no gout attack. In this case, we usually choose the timing of uric acid-lowering therapy with or without comorbidities. If the patient has hypertension, stroke, coronary heart disease, cardiac insufficiency, uric acid nephrolithiasis, diabetes and other comorbidities, and serum uric acid exceeds 480, uric acid-lowering therapy should be considered, and the target uric acid value should be 360; If there is no comorbidity, uric acid lowering therapy should be performed if it exceeds 540, and the target uric acid value can be reduced to 420.

●If the patient has developed gout and has no comorbidities, uric acid lowering therapy should be performed if the uric acid is higher than 480, and the goal is to reduce it to 360. If the patient has developed gout and has comorbidities, such as two or more gout attacks per year, tophi, chronic gouty arthritis, kidney stones, hypertension, diabetes, dyslipidemia, uric acid higher than 420 Serum uric acid treatment should be performed, and the target uric acid value should be 300.

05

Specific measures to lower uric acid!

● Whether patients with hyperuricemia or gout, need lifestyle intervention and dietary intervention. In daily life, try to choose ingredients with low purine and purine content, and pay attention to cooking methods, do not choose salt and oil content High cooking methods are more likely to cause abnormal uric acid. In daily life, it is necessary to drink more water, more than 2000 ml per day, and to increase the intake of eggs, milk, ingredients rich in vitamin C and vegetables can help reduce blood uric acid. Try not to drink alcohol, and do not drink more fructose-containing drinks.

In daily life, you should also insist on exercising, such as brisk walking, jogging, swimming, cycling and yoga, which are more soothing exercises, which are more suitable for gout patients.

● specific drug selection. The choice of drugs for gout patients is very particular. It is necessary to check which type of cause the patient belongs to, which leads to the occurrence of abnormal uric acid, such as the type of uric acid excretion disorder, the type of increased uric acid synthesis, or the combination of the two. The patient's liver and kidney function and other related tests are used to determine which drug is more suitable for a certain patient. Therefore, the choice of drug must be selected with the help of a professional rheumatologist or endocrinologist. You can take whatever medicine your gout patients take, which is risky.

06

Summarize

The problems of acidemia and gout are now too common. The number of people with hyperuricemia in our country has exceeded 170 million, and the number of gout patients has exceeded 17 million. It has become a social problem.

Faced with this problem, everyone must not take it lightly. You must regularly review your blood uric acid and monitor your uric acid status. Even if there is no special abnormality in your body, you should insist on a physical examination every six months to see if your blood uric acid is high. If you are high, you should discover your own problems in time, take timely interventions through lifestyle, and try not to use drugs to control blood uric acid.

If blood uric acid is too high or gout has already occurred, you should actively carry out drug control and lifestyle intervention according to the standards in the text, and try to avoid the harm caused by hyperuricemia and gout to the body. If you have other doubts You can leave a message below and let's discuss together.

I am Xie Xinhui, who insists on explaining the knowledge of complex diseases in simple language. It is not easy to code words. If you agree with my point of view, please help to follow or like it. If you or your family and friends are also troubled in this regard, please Forward this article to friends who need it, thank you!