Gout is a purine metabolic disorder and (or) uric acid excretion decreased blood uric acid increased metabolic disease. Gout patients to hospital often have the following questions: gout is not high uric acid, check a blood uric acid is not to go, why the doctor check will let me do something else?
In order to relieve the patient's doubts, let us to know more about gout related inspection, xi 'an hospital of traditional Chinese medicine has made to do the following instructions.
1, blood uric acid test
Known as high uric acid hematic disease can lead to gout, gout can cause acute and chronic, recurrent arthritis, blood uric acid level is high, gout prevalence is higher. High uric acid hematic disease, however, will not necessarily for the development of gout. Only when urate crystals in joints where deposition to a certain extent, gout occurs. At the same time, whether gout attacks also related with the movement and environmental factors, therefore, gout attack, the blood uric acid level does not necessarily will be very high. Although high uric acid hematic disease is the cause of gout, but they cannot simply draw the equal sign. Uric acid in addition to deposited in the joints, causing gout, is also likely to deposit in the kidney, cause kidney stones and kidney damage, severe cases will be developed into uremia. Gout is only one of the dangers of high uric acid hematic disease. Is the little-known, high uric acid hematic disease or type 2 diabetes, high blood pressure, independent risk factor for cardiovascular disease development.
High uric acid is the basic condition of gout attacks, so the detection of blood uric acid for the diagnosis of gout evaluation and drop uric acid treatment effect evaluation is very important.
High uric acid is helpful to the diagnosis of gout, but not all are abnormal in the determination of uric acid in patients with gout, often can be seen in acute gout attack, the patient's blood uric acid is not high, but in this case, the doctor can also according to the result of typical symptoms and other tests to diagnose gout.
High blood uric acid, d to drop uric acid after treatment, the patient is general should review every 3-5 weeks of blood uric acid, on this basis, the doctor to adjust uric acid drug doses or types, goal is to the blood uric acid have fallen to below 300 umol/L, uric acid is lower than this level, is more advantageous to the joint cavity of urate crystals dissolve and remove.
2, routine urine test
Routine urine test can understand urine PH, presence of protein in the urine, blood, etc., indirectly reflect the renal involvement. Gout patients with alkaline drugs alkalize urine, make the urine PH value of 6.2 to 6.2, the uric acid is not easy to accumulate form crystals in the urine, especially in promoting the uric acid excretion drugs, alkalize urine is more advantageous to uric acid eduction. Judge the curative effect of routine urine test, help doctors, timely adjustment of drug treatment.
3, serum creatinine, blood urea nitrogen (renal function)
Detection of serum creatinine, blood urea nitrogen level is to understand the renal function in patients with gout.
Above mentioned gout may cause kidney damage, and at the same time drop uric acid in patients with different kidney function of selection of drugs and doses have guiding significance.
4, liver function test
Check liver result of uric acid drug selection is very important. Such as the cloth company him, benzene bromide Malone all possible liver damage, so often should review after liver result, if abnormal hepatic function, should according to the specific situation, under the guidance of decrement, adjust or stop blood uric acid drugs.
5, blood glucose, blood lipid test
Gout and high uric acid hematic disease is related to metabolic disease, blood sugar, blood fat tests to assess the status of the patients with sugar, fat generation x, for existing glucolipid metabolism was abnormal, should give positive sugar, lipid adjusting treatment, for the gout and high uric acid hematic disease control is good.
6, uric acid detection
So patients can determine uric acid excretion condition, auxiliary selection uric acid drugs. Patients with a low purine diet for five days, the daily uric acid discharge exceeds 3.57 tendency for L (600 mg), increased formation of uric acid. Combined with the history of patients' renal function, urinary stones, urinary tract urinary stones are not found in B to exceed, drug treatment should be adopted for restrain uric acid formation. Application in promoting the uric acid test before and after medication urine uric acid, for doctors to judge the efficacy of treatment, adjustment of drug use.
7, renal ultrasound
Due to long-term high uric acid hematic disease, gout patients kidneys tend to have uric acid salt deposition, may be of urate crystals, stones, even so the renal ultrasound is necessary for every gout patients, as well as understand the kidney damage, can also help doctors choose more appropriate drop uric acid drugs.
8, joints, ultrasonic
Joint of ultrasonic "dual-track"
Joint ultrasound in recent years is widely used in rheumatology, if found on joint pain by ultrasound the typical "dual track", "the storm", can prompt gout, diagnosis and differential diagnosis of gout provides again - kind of highly effective, noninvasive examination method.
Warm prompt: in addition to this, gout patients suspected of normal blood uric acid, under the condition of the hospital has the related equipment and condition, can consider to use the auxiliary diagnosis dual-source CT. Also can undertake joint puncture pumping liquid, using polarized light microscopy, urate crystals in order to make clear diagnosis. Gout repeated attacks and chronic deferment, can appear the typical X-ray manifestation, patient joint X-ray help gout joint damage situation judgment.