Gout tshwm sim thaum purine metabolism cuam tshuam hauv tib neeg lub cev. Nyob rau tib lub sijhawm, qhov kev ntsuas siab tshaj ntawm uric acid pom nyob rau hauv cov ntshav, thiab articular thiab / lossis periarticular cov ntaub so ntswg, ob lub raum thiab lwm yam kabmob raug kev txom nyem los ntawm deposits ntawm urate - sodium urate ntsev.
Cas of gout
Ntau dhau ntawm uric acid yog tsim los ntawm kev ua kom muaj zog ntawm cov purines endogenous, txo qis ntawm urates, lossis kev sib xyaw ua ke ntawm cov txheej txheem no. Paub cov tsos mob ntawm tus kab mob thawj thiab theem nrab. Cov ntaub ntawv tom kawg yuav tsum ua tib zoo saib xyuas cov tshuaj noj los ntawm tus neeg uas raug mob los ntawm gout. Qhov ua rau tus kab mob no xav tau kev saib xyuas kom ntxaws.
Gout vim kev tsim cov uric acid ntau dhau
Qhov ntau dhau ntawm purine hauv paus thiab nucleosides yog qhov laj thawj tseem ceeb rau qhov siab ntawm uric acid. Nrog rau kev noj zaub mov tsis txwv, uas muaj ntau cov purine-forming substrates, overproduction ntawm acid ib txwm tshwm sim.
Cov tsos mob ntawm kev tsim tawm theem nrab yog tshwm sim los ntawm cov cell tawg ntau dhau los tawm tsam keeb kwm ntawm qee yam kab mob (piv txwv li, hemoblastosis, paraproteinemia, hemolysis,cawv, tshuaj kho mob cancer). Hyperuricemia feem ntau nrog psoriasis. Txawm li cas los xij, kev kho mob pathology ntawm gout hauv cov xwm txheej no tshwm sim tsis tshua muaj.
Gout vim txo qis tso zis ntawm uric acid
90% ntawm cov neeg uas muaj lub nra hnyav rau tus kab mob gout tau txo cov kua qaub rho tawm. Lub raum, hnyuv thiab daim tawv nqaij pab kom tawm hauv lub cev ntawm uric acid. Nrog txo qis excretion ntawm urates los ntawm ob lub raum, lawv khaws ntau tshaj nyob rau hauv lub cev thiab crystallize. Cov pob zeb me me tau tso rau hauv cov pob qij txha, ua rau mob thiab mob. Thiab lub raum raug cuam tshuam los ntawm urate nephritis.
qhov tshwm sim no qee zaum tshwm sim los ntawm diuretics, cawv, acetylsalicylic acid, aminophylline, caffeine, diazepam, diphenhydramine, L-dopa, dopamine, vitamins B 12 thiab C hauv koob tshuaj me me. Cov hmoov txhuas ua rau muaj kev sib kis. Lead gout yog tshwm sim los ntawm cov xim, surrogate cawv thiab lwm qhov chaw uas muaj hlau hnyav.
Cov tsos mob ntawm gout: cov cim ntawm kev tawm tsam
Qhov tshwm sim ntawm cov tsos mob yog txuam nrog cov ntsev uas tsim los ntawm uric acid. Crystals nyob rau hauv cov pob qij txha thiab ob lub raum. Thawj qhov kev tawm tsam ntawm gout feem ntau tsis tshwm sim ua ntej hnub nyoog peb caug. Nws tau ntsib ntau zaus los ntawm cov neeg mob uas muaj hnub nyoog 40-60.
Kev tawm tsam yog nrog los ntawm o thiab liab ntawm pob qij txha, mob hnyav. Yog tsis muaj kev kho mob, nws tsis ploj mus rau ob peb hnub thiab txawm lub lis piam. Hmo ntuj thiab hmo ntuj yog lub sijhawm tseem ceeb rau kev pib qaug dab peg.
Ib tug kab mob gout yog provoked los ntawm kev noj cov nqaij nplua nuj,dej cawv, qee yam ntses, kas fes thiab lwm yam khoom uas muaj purine hauv paus. Tus kab mob feem ntau cuam tshuam rau tus ntiv taw loj, txawm tias kev puas tsuaj rau lwm cov pob qij txha tsis raug cais tawm. Nws cov tsos mob tshwm sim yog mob caj dab, uas ua rau tsis zoo rau lub raum pathologies.
Acute gout
mob caj dab yog ib hom mob gout. Nws yog qhia nyob rau hauv ib tug tam sim ntawd nres ntawm gout - ib tug mob o ntawm lub pob qij txha. Hauv gouty mob caj dab, urate crystals poob tawm ntawm cov ntaub so ntswg mus rau hauv cov kab noj hniav sib koom ua ke, ua rau mob. Gout tawm tsam feem ntau tshwm sim thaum nruab nrab hmo ntuj.
Ua rau haus cawv, raug mob, lub cev dhau, kev phais, ntau yam tshuaj gout. Kev kho mob nrog tshuaj tuaj yeem txo qhov qaug dab peg thiab txo qhov mob. Thaum lub sij hawm tawm tsam, cov ntaub so ntswg sib koom ua ke thiab cov ntaub so ntswg swell, daim tawv nqaij ntawm qhov chaw ntawm lub ntsej muag tig liab, qhov mob nce ntxiv.
Kev mob caj dab mob hnyav ploj hauv ob peb hnub (qee lub lis piam), txawm tias lawv tsis kho. Kev tawm tsam rov qab los tom qab rau lub hlis lossis ib xyoos. Txawm hais tias lub sijhawm ntawm kev ntsiag to qee zaum ntev txog 10-20 xyoo. Hauv cov neeg uas tsis xav tsis thoob los ntawm kev kho mob, qhov zaus ntawm kev tawm tsam nce, ob peb pob qij txha tau koom nrog lawv tib lub sijhawm. Lub sijhawm ntawm kev tawm tsam nce ntxiv, lawv tau tshaj tawm.
mob gout
Cov kab mob ntev ntev yog nrog cov cim qhia:
- mob caj dab;
- sau ntawm urate crystals;
- raum puas.
Ntau tus kab mob gout yog nrog txhua yam tsos mob tib lub sijhawm. Kev mob caj dab ntev cuam tshuam rau cov neeg uas tau muaj txoj sia nyob ntawm tus kab mob thib ob, kho tsis tau sijhawm lossis kho tsis tau zoo.
Thaum lub raum raug cuam tshuam, muaj 3 hom kev hloov:
- raum cov ntaub so ntswg overgrown nrog urate crystals. Cov tshuaj tiv thaiv mob me me ntws hauv lawv.
- Intrarenal urinary kab mob txhaws nrog urate crystals.
- Uric acid pob zeb tau tsim nyob rau hauv cov zis.
Kev hloov kho tau ua ke hauv ntau yam kev hloov pauv, ua rau lub sijhawm kho mob "gouty raum". Pob zeb nyob rau hauv cov zis tej zaum yuav asymptomatic los yog qhia cov tsos mob ntawm urolithiasis.
Kev kho mob
Lub hom phiaj ntawm kev kho mob yog txhawm rau tiv thaiv kab mob gout thiab txo kev mob caj dab. Los ntawm kev tswj hwm kev haus dej kom txaus, kev poob phaus, kev noj zaub mov noj, txo cov tshuaj uas ua rau hyperuricemia, thiab tshem tawm cawv, tiv thaiv kab mob gout. Kev kho tshuaj tuaj yeem tshem tawm qhov mob thiab mob.
Dej txo cov concentration ntawm urates, tiv thaiv kom tsis txhob poob rau hauv cov pob zeb uas nyob hauv cov ntaub so ntswg thiab cov kab mob. Tsis tas li ntawd, nws pab ntxuav lawv tawm thiab tshem tawm ntawm lub cev. Cawv muaj peev xwm ua rau cov nyhuv diuretic. Nyob rau hauv loj koob tshuaj, nws dehydrates lub cev, pab mus rau crystallization ntawm ntsev, pib gouty tawm tsam. Tsis tas li ntawd, nws maj mam tso tawm cov urates los ntawm lub cev, muab lub sijhawm rau lawv tso rau hauv cov pob qij txha.
Kev poob phaus pab txo qhov kev pheej hmoo ntawm tus mob goutyqaug dab peg. Kev noj zaub mov yuav tsum txo cov rog thiab txo calories. Kev noj zaub mov ua ke nrog kev tawm dag zog aerobic tsis tu ncua.
Drug therapy
Lub ntsiab tseem ceeb uas tswj cov kab mob gout yog kev kho mob nrog cov tshuaj uas txo qhov mob, tshem tawm cov tshuaj tiv thaiv kab mob, tswj cov metabolism hauv kev cuam tshuam, ua rau hyperuricemia. Kev siv tshuaj loog yog ua nrog acetaminophen (Tylenol) lossis lwm yam tshuaj muaj zog ntxiv.
Ntawm cov tshuaj uas tsis yog-steroidal anti-inflammatory, indomethacin raug pom zoo. Muaj tseeb, nws tsis haum rau cov neeg mob ua xua rau cov tshuaj aspirin thiab cov neeg mob uas muaj qhov ntswg polyps. Colchicine yog tsim los pab txo qhov mob gouty.
Kev tshuaj xyuas tus neeg mob hais meej tias cov tshuaj noj hauv qhov ncauj muaj cov kev mob tshwm sim loj heev uas cuam tshuam nrog kev siv ntau zaus (ib teev lossis ob teev kom txog thaum qhov mob txo qis lossis tshwm sim tsis zoo tshwm sim).
Corticosteroids, tus neeg sawv cev muaj zog tiv thaiv kab mob, txo cov kev tawm tsam hnyav. Txhawm rau kom tsis txhob muaj kev phiv ntev mus ntev, lawv tau muab tshuaj rau hauv cov kev kawm luv luv. Lawv raug muab tshuaj rau cov neeg mob uas muaj kab mob sib kis ntawm lub siab thiab lub raum.
Nyob ntev, cov neeg mob noj cov tshuaj uas txo cov concentration ntawm uric acid hauv cov ntshav. Lawv pab txhawb rau kev sib cais ntawm hnyav tofus deposits, tiv thaiv pob zeb tsim thiab kev loj hlob ntawm pathologies nyob rau hauv lub raum. Ua tsaug rau lawv, gout tsis tshwm sim. Kev kho mobCov tshuaj los ntawm pawg no tuaj yeem ua rau kom cov zis tawm ntawm urates lossis txo lawv cov synthesis los ntawm cov khoom noj purines.
Cov tshuaj no tuaj yeem ua rau mob gouty, yog li lawv tau noj tom qab cov txheej txheem inflammatory tau ploj mus. Yog tias lawv tau kho ua ntej muaj kev tawm tsam, chav kawm tsis cuam tshuam, tab sis lawv sim kho qhov ntau npaum li cas (tshwj xeeb tshaj yog tom qab nws ploj mus). Vim tias ntau tus neeg mob uas muaj uric acid ntau ntau tsis tsim cov pob zeb hauv lub raum lossis raug kev txom nyem los ntawm gout, cov tshuaj uas cuam tshuam rau qib urate yog ib tus neeg heev.
Nrog kev pab ntawm probenecid thiab sulfinpyrazone, lawv ua rau kom cov kua qaub uric nce ntxiv. Cov tshuaj no tsis haum rau kev kho cov neeg mob urolithiasis. Lawv qee zaum provoke tsim cov pob zeb. Kev haus dej kom ntau, ua ke nrog lawv cov kev noj haus, txhawb kev nrawm nrawm ntawm cov kua qaub los ntawm cov zis thiab tiv thaiv kev tsim cov conglomerates.
Ua tsaug rau allopurinol tiv thaiv kev sib txuas ntawm uric acid. Lawv thaiv kev hloov pauv metabolic ntawm purine hauv paus rau hauv cov kua qaub. Nws tau ceev faj tau sau tseg vim muaj kev pheej hmoo ntawm cov kev mob tshwm sim hauv cov neeg uas muaj lub raum tsis ua haujlwm.
Siv tshuaj hauv tsev
Kev kho mob hauv tsev pab txo cov tsos mob ntawm tus mob gout. Cov kab mob sib kis tau nce, muab kev thaj yeeb nyab xeeb. Qhov mob yog relieved los ntawm kev siv dej khov. Tsis txhob noj cov tshuaj aspirin (lawv inhibit qhov excretion ntawm uric acid).
Lawv tau kho nrog cov nroj tsuag tshuaj: sawv hips thiab hiav txwv buckthorn, lingonberries thiabstrawberries, roob tshauv thiab blueberries, barberry thiab St. John's wort, birch thiab linden, chicory thiab lwm yam tshuaj ntsuab. Lawv siv cov tshuaj homeopathic.
YKev noj haus rau gout
Ua raws li kev noj haus muab kev tso cai ruaj khov. Qhov zoo tshaj plaws, ua tiav kev tshem tawm cov khoom noj purine-fortified tiav. Yog tias qhov kev cais tawm tsis tuaj yeem ua tau, qhov kev txwv siab tshaj plaws ntawm lawv cov khoom noj tau qhia. Lawv sim sib npaug cov roj thiab haus kom ntau.
Anchovies, sardines, goose, nqaij qaib thiab tej nqaij rog, offal, nqaij rho tawm, legumes thiab qhuav cawu cub yog nplua nuj nyob rau hauv purines. Thaum kuaj pom tus mob gout, txiv lws suav tau noj hauv qhov nruab nrab.
Txiv lws suav muaj cov organic acids. Tsis muaj ntau npaum li purines hauv lawv li, piv txwv li, hauv nqaij. Yog li ntawd, cov kws kho mob tsis txwv cov neeg mob gout los ntawm kev noj txiv lws suav. Ntawm qhov tsis sib xws, lawv ntseeg tias qhov tsim nyog ntawm cov txiv lws suav thiab cov tais diav los ntawm lawv muaj txiaj ntsig zoo rau cov neeg mob no.
