这些高尿酸血症的小知识，您知道吗？
<h2 style="outline: 0px;font-weight: bold;max-width: 100%;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;white-space: normal;background-color: rgb(255, 255, 255);line-height: 1.6em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br/></h2><p><section><section><section><section data-autoskip="1"><section data-support="96编辑器" data-style-id="33668"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display: inline-block;background-color: rgb(255, 0, 0);padding: 2px;border-radius: 55px;box-sizing: border-box;"><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 255, 255);padding: 3px 15px;letter-spacing: 2px;color: rgb(254, 254, 254);font-size: 16px;border-radius: 55px;box-sizing: border-box;"><p><strong>什么是高尿酸血症？</strong></p></section></section></section></section></section></section></section></section></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"> </span><span style="font-size: 16px;color: rgb(255, 76, 65);">高尿酸血症是嘌呤代谢紊乱引起的代谢异常综合征</span><span style="font-size: 16px;">。根据《中国高尿酸血症与痛风诊疗指南（2019）》，成年人，不分男女，非同日两次空腹血尿酸＞420umol/L即诊断为高尿酸血症。</span></p><p><section data-support="96编辑器" data-style-id="26976"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="width: 102px;height: 65px;border-top: 2px dotted #f00;border-left: 2px dotted #f00;box-sizing: border-box;"><br/></section><section style="padding-right: 12px;padding-left: 12px;margin-top: -55px;box-sizing: border-box;"></section><section style="display: flex;justify-content: flex-end;margin-top: -55px;"><section style="width: 102px;height: 65px;border-bottom: 2px dotted #f00;border-right: 2px dotted #f00;box-sizing: border-box;"><span style="letter-spacing: 1px;"></span><br/></section></section></section></section></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;letter-spacing: 1px;"> </span><span style="font-size: 16px;color: rgb(255, 76, 65);">高尿酸血症具有高患病率的特点</span><span style="font-size: 16px;">，中国大陆高尿酸血症的患病率为13.3%，患病人数超过1.2亿，是继高血压、糖尿病后第三大代谢类疾病，高尿酸血症可导致痛风，中国大陆痛风的患病率为1.1%，患病人数已超过1700万。</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;"> </span>高尿酸血症与痛风、肾结石和慢性肾脏病有明确的因果关系，约2%的高尿酸血症患者出现痛风，高尿酸血症患者尿毒症的发病率明显升高，男性约增加4倍，女性增加9倍。近年来，高尿酸血症引起越来越多的人关注，是因为越来越多的研究发现，血尿酸升高时心脑血管疾病、高血压、糖尿病等疾病的独立危险因素。</span><span style="font-size: 16px;"></span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><br/></span></p><p><section data-support="96编辑器" data-style-id="33668"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display: inline-block;background-color: rgb(255, 0, 0);padding: 2px;border-radius: 55px;box-sizing: border-box;"><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 255, 255);padding: 3px 15px;letter-spacing: 2px;color: rgb(254, 254, 254);font-size: 16px;border-radius: 55px;box-sizing: border-box;"><p><strong><span style="letter-spacing: 0.5px;">高尿酸血症究竟会带来哪些心脑血管损害呢？</span></strong><span style="letter-spacing: 1px;color: rgb(51, 51, 51);text-align: justify;"></span></p></section></section></section></section><section data-support="96编辑器" data-style-id="26976"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="width: 102px;height: 65px;border-top: 2px dotted #f00;border-left: 2px dotted #f00;box-sizing: border-box;"><br/></section><section style="padding-right: 12px;padding-left: 12px;margin-top: -55px;box-sizing: border-box;"></section><section style="display: flex;justify-content: flex-end;margin-top: -55px;"><section style="width: 102px;height: 65px;border-bottom: 2px dotted #f00;border-right: 2px dotted #f00;box-sizing: border-box;"><br/></section></section></section></section></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;"> </span>高尿酸血症增加高血压的发病危险，有研究显示，血尿酸每增加77umol/<span style="font-size: 16px;letter-spacing: 1px;">L</span>，高血压发生危险增加13%，我国青少年高血压患者90%合并高尿酸血症，40%-60%成年人高血压患者合并高尿酸血症。血尿酸增高显著增加冠心病的发病率和死亡率，使得心肌梗死发病率增加2.5倍，死亡率增加5倍，心肌梗死患者当血尿酸＞381umol/<span style="font-size: 16px;letter-spacing: 1px;">L</span>时死亡率增加18%。高尿酸血症是脑卒中的独立危险因素，使得脑卒中的发病率增加3倍，死亡率增加10倍。</span><span style="font-size: 16px;"></span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><br/></span></p><p><section data-support="96编辑器" data-style-id="33668"><section style="margin-top: 10px;margin-bottom: 10px;text-align: center;"><section style="display: inline-block;background-color: rgb(255, 0, 0);padding: 2px;border-radius: 55px;box-sizing: border-box;"><section style="border-width: 1px;border-style: solid;border-color: rgb(255, 255, 255);padding: 3px 15px;letter-spacing: 2px;color: rgb(254, 254, 254);font-size: 16px;border-radius: 55px;box-sizing: border-box;"><p><span style="letter-spacing: 0.5px;"><strong>高尿酸血症危害如此大，我们该怎么样控制呢？</strong></span></p></section></section></section></section></p><p style="letter-spacing: 1px;line-height: 2em;"><strong><span style="font-size: 16px;color: rgb(255, 76, 65);">1、生活方式干预 </span><span style="font-size: 16px;"> </span></strong><span style="font-size: 16px;"></span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;"> </span><strong>控制体重</strong>：保持BMI＜24kg/m^2；</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;"> </span><strong>规律运动</strong>：痛风急性期暂缓运动，缓解期保持中等强度运动，每周运动时间为150分钟，运动方式可以选择如快走、慢跑、骑车、太极拳、健美操、广场舞、游泳、乒乓球等球类运动。</span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;"> </span><strong>限制高危食品</strong>：限制饮酒、高嘌呤、高果糖饮食。鼓励饮用奶制品、多进食新鲜蔬菜、适量饮水。每日建议饮水量2-3L，建议睡前多饮水，避免夜间尿液浓缩导致尿路结石形成，适量补充碳酸氢钠，高尿酸血症患者保持尿PH在6.2-6.9，痛风患者保持6.1-7.0。豆制品因为不同制作方式对尿酸的影响不一致，故豆制品不推荐也不限制。</span><span style="font-size: 16px;"></span></p><p><section data-support="96编辑器" data-style-id="26976"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="width: 102px;height: 65px;border-top: 2px dotted #ff0000;border-left: 2px dotted #ff0000;box-sizing: border-box;"><br/></section><section style="padding-right: 12px;padding-left: 12px;margin-top: -55px;box-sizing: border-box;"></section><section style="display: flex;justify-content: flex-end;margin-top: -55px;"><section style="width: 102px;height: 65px;border-bottom: 2px dotted #ff0000;border-right: 2px dotted #ff0000;box-sizing: border-box;"><br/></section></section></section></section></p><p style="letter-spacing: 1px;line-height: 2em;"><strong><span style="font-size: 16px;color: rgb(255, 76, 65);">2、合理治疗</span></strong><span style="font-size: 16px;color: rgb(255, 76, 65);"></span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;"><span style="font-size: 16px;letter-spacing: 1px;"> </span></span><strong>每个高尿酸血症患者基本都在犹豫我要不要吃降尿酸的药物，吃了药物要吃多久呢？控制到什么程度呢？</strong></span></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;"><span style="font-size: 16px;letter-spacing: 1px;"> </span></span>根据《中国高尿酸血症与痛风诊疗指南（2019）》，所有高尿酸血症当血尿酸＞540umol/L均需要启动降尿酸药物治疗，建议长期服用药物维持血尿酸水平＜420umol/L；对伴有高血压、脂代谢异常、糖尿病、肥胖、脑卒中、冠心病、心功能不全等，当血尿酸＞480umol/L需要启动降尿酸药物治疗，并维持血尿酸水平＜360umol/L。所有痛风患者当血尿酸＞480umol/L，均需要启动降尿酸药物治疗，建议长期服用药物维持血尿酸水平＜360umol/L；对痛风发作次数≥2次/年及伴有痛风石、慢性痛风性关节炎、肾结石、慢性肾脏疾病、高血压、糖尿病、 血脂异常、脑卒中、缺血性心脏病、心力衰竭和发病年龄＜40岁等，当血尿酸＞420umol/L，需要启动降尿酸药物治疗，并维持血尿酸水平＜300umol/L。</span><span style="font-size: 16px;"></span></p><p><section data-support="96编辑器" data-style-id="26976"><section style="margin-top: 10px;margin-bottom: 10px;"><section style="width: 102px;height: 65px;border-top: 2px dotted #f00;border-left: 2px dotted #f00;box-sizing: border-box;"><br/></section><section style="padding-right: 12px;padding-left: 12px;margin-top: -55px;box-sizing: border-box;"></section><section style="display: flex;justify-content: flex-end;margin-top: -55px;"><section style="width: 102px;height: 65px;border-bottom: 2px dotted #f00;border-right: 2px dotted #f00;box-sizing: border-box;"><br/></section></section></section></section></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;"><span style="font-size: 16px;letter-spacing: 1px;"><span style="font-size: 16px;letter-spacing: 1px;"> </span></span>所有高尿酸血症与痛风患者应知晓需终身将血尿酸水平控制在240μmol/L以上并维持在目标控制范围以下，并为此可能需要长期甚至终生服用降尿酸药物。</span><span style="font-size: 16px;">在选用药物的时候需要根据患者高尿酸血症的分型、是否合并痛风发作、肝肾功能、心脑血管疾病等综合来选择，通过监测血尿酸水平、尿常规、痛风发作次数及肝肾功能等情况来调整药物剂量等。</span><br/></p><p style="letter-spacing: 1px;line-height: 2em;"><span style="font-size: 16px;letter-spacing: 1px;"> </span><span style="font-size: 16px;color: rgb(0, 0, 0);"><strong>需要提醒的是</strong></span><span style="font-size: 16px;">，在中国人群中使用应特别关注别嘌醇超敏反应，有数据显示在(中国台湾地区超敏反应发生率为2.7％，而一旦发生，致死率高达30％。因为别嘌醇超敏反应的发生与HLA-B*5801存在明显相关性，且汉族人群携带该基因型的频率为10％~20%。因此对于首次拟选用别嘌醇作为降尿酸药物时候，建议完善HLA-B*5801基因检测，特 别 是 eGFR<60ｍl·min-1·(1.73ｍ2) -1的高尿酸血症和痛风患者，对于阳性患者，国内外指南均不推荐使用别嘌醇。</span></p><p><section data-style-id="30285" style="outline: 0px;max-width: 100%;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;white-space: normal;background-color: rgb(255, 255, 255);box-sizing: 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!important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;box-sizing: border-box;display: inline-block;width: 665.997px;vertical-align: top;background-color: rgba(255, 255, 255, 0);border-style: solid;border-width: 1px;border-radius: 0px;border-color: rgb(7, 48, 196);overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: 10px;outline: 0px;max-width: 100%;display: flex;flex-flow: row nowrap;text-align: left;justify-content: flex-start;transform: translate3d(-8px, 0px, 0px);box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;display: inline-block;vertical-align: top;width: auto;line-height: 0;letter-spacing: 0px;flex: 0 0 0%;height: auto;align-self: flex-start;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 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0px;max-width: 100%;box-sizing: border-box;color: rgb(62, 62, 62);letter-spacing: 1.8px;line-height: 1.8;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;">1、咨询株洲恺德心血管病医院订阅号<strong style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="outline: 0px;max-width: 100%;color: rgb(7, 48, 196);box-sizing: border-box !important;overflow-wrap: break-word !important;">在线客服；</span></strong><br data-filtered="filtered" style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"/>2、咨询电话：<strong style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="outline: 0px;max-width: 100%;color: rgb(7, 48, 196);box-sizing: border-box !important;overflow-wrap: break-word !important;">0731-28260137</span></strong></section><section style="outline: 0px;max-width: 100%;line-height: 2em;box-sizing: border-box !important;overflow-wrap: break-word !important;">3、联系地址：株洲恺德心血管病医院<span style="outline: 0px;max-width: 100%;color: rgb(7, 48, 196);box-sizing: border-box !important;overflow-wrap: break-word !important;"><strong style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;">第二住院大楼3楼（心血管内三科）</strong></span></section></section></section></section></section></section></section></section><section style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;letter-spacing: 0.544px;text-align: right;font-size: 12px;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="margin-top: 10px;margin-bottom: 10px;outline: 0px;max-width: 100%;font-size: 16px;letter-spacing: 0.544px;box-sizing: border-box !important;overflow-wrap: break-word !important;"><section style="outline: 0px;max-width: 100%;box-sizing: border-box;border-top: 1px solid rgb(7, 48, 196);line-height: 0;overflow-wrap: break-word !important;"><section data-filtered="filtered" style="outline: 0px;max-width: 100%;line-height: 0;width: 0px;box-sizing: border-box !important;overflow-wrap: break-word !important;"><svg viewbox="0 0 1 1" style="vertical-align:top;"></svg></section></section><section style="margin-top: 3px;outline: 0px;max-width: 100%;box-sizing: border-box;border-top: 4px solid rgb(7, 48, 196);line-height: 0;overflow-wrap: break-word !important;"><section data-filtered="filtered" style="outline: 0px;max-width: 100%;line-height: 0;width: 0px;box-sizing: border-box !important;overflow-wrap: break-word !important;"><svg viewbox="0 0 1 1" style="vertical-align:top;"></svg></section></section></section><section style="outline: 0px;max-width: 100%;letter-spacing: 0.544px;box-sizing: border-box !important;overflow-wrap: break-word !important;"><p style="outline: 0px;max-width: 100%;box-sizing: border-box !important;overflow-wrap: break-word !important;"><span style="outline: 0px;max-width: 100%;letter-spacing: 0.544px;box-sizing: border-box !important;overflow-wrap: break-word !important;">文案：刘平平</span><span style="outline: 0px;max-width: 100%;letter-spacing: 0.544px;font-size: 17px;text-align: justify;box-sizing: border-box !important;overflow-wrap: break-word !important;"></span></p></section></section></section></section></p><h2 style="outline: 0px;font-weight: bold;max-width: 100%;font-family: -apple-system, BlinkMacSystemFont, Helvetica Neue, PingFang SC, Hiragino Sans GB, Microsoft YaHei UI, Microsoft YaHei, Arial, sans-serif;letter-spacing: 0.544px;white-space: normal;background-color: rgb(255, 255, 255);line-height: 1.6em;box-sizing: border-box !important;overflow-wrap: break-word !important;"><br/></h2><p><br/></p><link rel="stylesheet" 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