First, women rarely develop gout before menopause
Second, the presence of hyperuricemia alone does not diagnose gout
In fact, people with elevated uric acid levels may never have an acute gout attack; on the contrary, acute gout attacks may occur while blood uric acid levels are normal.
Obesity and diabetes mellitus are good factors for gout
Local injury to joints, tight shoes, walking, full meals and alcohol, excessive fatigue, cold and wet, infection and surgery can induce acute gout attacks.
Fourth, gout patients drink a lot of water every day
It can promote uric acid excretion and prevent high uric acid values in the blood. Experts recommend that people with high uric acid or gout drink at least 2500 ml of water every day, including 500 ml in the morning, 1 glass of water every 3-4 hours during the day, and a moderate amount of water before going to bed at night.
Fifth, in addition to limiting the intake of alcohol and high purine diet, gout patients should also limit the intake of total carbohydrates
Increase the intake of protein and unsaturated fatty acids, because these can enhance insulin sensitivity, thus promoting the decline of blood uric acid levels.
Sixth, clinical observation found that
The long-term application of small doses of aspirin (75-325mg/d) may damage the renal function of the elderly and reduce the clearance rate of uric acid; certain antihypertensive drugs containing diuretics may affect uric acid excretion and induce gout, which should be noted.
VII. Diagnostic criteria of gout.
(a) Characteristic urate crystals in the joint fluid.
(ii) chemical method or polarized light microscopy to confirm the presence of urate crystals in gout nodules
(iii) With 6 or more of the following 12 criteria
1.More than 1 episode of acute arthritis.
2. inflammatory response peaking within 1 day.
3. acute monoarthritic episodes.
4. dark red skin visible in the affected joint.
5. pain or swelling of the first metatarsophalangeal joint.
6, unilateral arthritis attack involving the first metatarsophalangeal joint.
7. unilateral arthritic attacks involving the tarsal joints.
8.Suspected gout nodules.
9, hyperuricemia.
10.X-ray radiography showing asymmetric intra-articular swelling.
11. Radiographs showing subcortical cysts without erosion.
12. Negative microbiological culture of joint fluid during arthritis attack.
Gout can be diagnosed if any one of the above conditions is met.
VIII. Content of purines in food.
1. Foods containing trace purines (can be consumed daily): refined rice, flour, macaroni, finely processed cornmeal, cakes, cookies Milk, cheese, cream, ice cream, eggs and their products. Vegetables (except those high in purines), various fruits, vegetable oils, animal oils, peanuts, almonds, walnuts, chocolate, sugar, tea.
2.Foods containing less than 75 mg of purines (can be chosen daily or five days a week during the remission period): cereals, chicken, lamb, tripe, eel, salmon, white fish, tuna, herring, crab, lobster, etc.
3.Food containing 75-150 mg purine: lobster (asparagus), spinach, lentils, mushrooms, fresh peas, beef, beef tongue, pork, turkey, pigeon, wild duck, quail, carp, halibut, dried beans, etc.
4, containing 150-1000 mg purine food (both acute and remission should be prohibited): beef loin, beef and lamb liver, beef and lamb pancreas, heart, brain, meat pies, goose, partridge (spotted chicken, stone chicken), all kinds of meat and poultry made of thick soup, meat essence, sardines, anchovies, fish roe, mackerel, (fish is) fish, small shrimp, fetal shell (worm ho), tamari), yeast.
Nine, the dietary principles of gout patients.
1, obese people or overweight patients should be appropriate weight control, increase physical activity.
2, moderate amount of protein, can use milk, eggs, cheese, etc.
3.Low fat diet.
4.Food rich in vitamins and inorganic salts.
5.In the absence of renal insufficiency, maintain 2000-3000ml of drinking water daily to increase the excretion of uric acid.
Ten, the treatment of gout patients should pay attention to.
1, diet control, avoid triggers, prevent concomitant diseases (hyperlipidemia, diabetes, hypertension, coronary heart disease, cerebrovascular disease, etc.).
2.Non-steroidal anti-inflammatory drugs are preferred for treatment in the acute phase; colchicine can terminate acute attacks or prevent attacks; hormones are not used as the first choice of treatment, but only when the application of the above drugs is ineffective.
3.The treatment of intermittent and chronic period is mainly to reduce uric acid and prevent acute attacks.