Will excessive uric acid cause gout? Does normal uric acid prevent gout? the doctor told 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 how much it will cause gout is very complicated, because some people have particularly high uric acid and do not develop gout, while others The patient had normal blood uric acid, but also developed gout. Today we will talk about this issue.
02
The pathological basis of gout attacks is hyperuricemia!
Usually, if the results of the same patient’s two consecutive measurements on different days on an empty stomach exceed 420, it can be diagnosed as hyperuricemia. If you can adhere to a low-purine or medium-purine diet and do not drink alcohol, 3~5 days to measure, this value will be more accurate.
If our blood uric acid exceeds the normal value, then the 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 parts of the body Parts, including ears, including bone marrow can be deposited. A small amount of urate deposition may not cause special problems, but these deposited urate crystals will become more and more, and when they are strong enough, they may initiate riots and cause patients' death. A gout attack.
However, it does not mean that hyperuricemia will definitely develop gout. Generally, 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 people per 1,000 people will have the possibility of developing gout. Over 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, the current research has proved that being in a state of high uric acid for a long time 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, and will It will increase the risk of diabetes by 17%, and will lead to a 12% increase in the mortality rate of patients with coronary heart disease.
In addition, it is also found that many patients are in the state of subclinical gout, that is to say, although the patients have not had gout, due to the long-term increase in blood uric acid, the joints of the patients have been damaged, and some severe patients today have cartilage and subchondral Both bones are damaged, but the patient is asymptomatic. Long-term blood uric acid is higher than normal, which will also increase the possibility of kidney stones.
Generally speaking, even if a patient with hyperuricemia does not develop gout, the 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 a gout patient’s uric acid is well controlled, the chance 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 pay attention, this is not 100% non-recurrence, because urate crystals are still deposited in the body of gout patients, sometimes it may not be diet factors that induce gout attacks, it may be a cold, a trauma or a stay up late , poor rest may also lead to the onset of gout.
In addition, there is another possibility that the uric acid has been normal, but gout will recur repeatedly, that is, the crystal dissolution phenomenon that occurs in gout patients during the period of drug lowering uric acid. 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, the blood uric acid is reduced, and these uric acid crystals will be mobilized to dissolve into the blood, so it is easy to cause the attack of gout. This phenomenon is called the crystal dissolution phenomenon. 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 already developed gout and has no comorbidities, and the uric acid is higher than 480, uric acid-lowering treatment should be carried out, 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!
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, resulting in abnormal uric acid, such as uric acid excretion disorder, uric acid synthesis, or both. The patient's liver and kidney function and other related tests are used to choose which drug is more suitable for a certain patient, so the choice of drug must be made 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 too common now. 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 control blood uric acid by means of drugs.
If the 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!