How to manage the hidden period of gouty arthritis?

*For reference only for medical professionals, it will be too late if you die.
"Xiao Gao, how about we have a few more drinks today?" "Brother, I stopped drinking today.
Said not to drink alcohol, not to eat seafood!" "High uric acid? That is, gout, I understand that, there are many relatives in my family who have gout, it's okay, they all say that there is no pain and no treatment.
Just a few days
.

" "But the doctor clearly told me that the focus of high uric acid is on daily management.
You can't wait for the gout attack, and you need to treat it if it doesn't hurt
.

" "Really? It’s like a normal person at the time.
Isn’t it said that gout and gout come and go like wind.
Isn’t this an acute disease? Why do you have to treat it as usual, so it’s not a chronic disease?” “It seems that I am now in a hidden period of gouty arthritis.
What is the relationship between uric acid and gout? I don’t drink alcohol, and it’s not enough to complete the physical examination.
I have to go to an endocrinologist to find out!” What does the hidden period of gouty arthritis mean? What kind of concealment method? Ignore it during the concealment period.
If the gout does not attack, it will not be treated, right? If treatment is required, how should it be managed? Today, the Endocrinology Department of the Southern Theater General Hospital will answer these questions for you
.

01What does the hidden period of gouty arthritis mean? What is the relationship between high uric acid and gout? The hidden period of gouty arthritis refers to only fluctuating or persistent hyperuricemia without acute attacks, that is, joint redness, swelling, heat and pain
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Hyperuricemia is a metabolic abnormal syndrome caused by purine metabolism disorder and/or uric acid excretion disorder.
Whether male or female, the blood uric acid level exceeds 420 μmol/L twice on different days, and the diagnosis can be made
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The long-term elevation of uric acid exceeds the upper limit that the blood can hold, and uric acid crystals will be formed and deposited in the joints, auricles and even the kidneys.
Accumulation to a certain extent will lead to an acute attack of gout
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The period in which uric acid crystals accumulate silently without an acute attack is called the occult period
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02The hidden period of gouty arthritis is painless and will not be cured, right? Figure 1 Everyone may think that hyperuricemia is rare, and that it exists only in coastal populations with a family history of gout
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But in fact, with the advent of the people's better life, different dietary structures and life>
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Hyperuricemia is a chronic, systemic disease.
In addition to increasing the risk of gout, long-term hyperuricemia can also lead to vascular damage, kidney damage, metabolic disorders, hair loss and even male erectile dysfunction
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What's more, there is a lot of evidence that hyperuricemia is an independent risk factor for chronic kidney disease, hypertension, cardiovascular and cerebrovascular diseases, diabetes and other diseases, and an independent predictor of premature death
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Moreover, the incidence of hyperuricemia is getting younger and younger.
If you do not pay attention to management when you are young, when you reach a certain age, major heart, brain and kidney diseases will come to you
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Therefore, it is wrong to turn a blind eye to hyperuricemia and treat it without pain
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Figure 203 How to manage the hidden period of gouty arthritis? First, pay attention to outpatient follow-up
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Because there are no typical symptoms, the level of uric acid is an important indicator to determine whether the treatment is effective or not.
It is generally recommended to check once a month, and once every 2-3 months after stabilization; secondly, the control target of hyperuricemia should be defined
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If you have been healthy and have no other underlying diseases, it is recommended to control uric acid below 420 μmol/L; if you have been complicated with hypertension, hyperlipidemia, diabetes, obesity, stroke, coronary heart disease, uric acid kidney stones, and cardiac insufficiency , renal insufficiency, it is recommended to control uric acid below 360μmol/L; the last is the treatment plan
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Not all diseases need to be treated with drugs and surgery.
The preferred treatment methods for gouty arthritis in the latent period are diet and exercise control, and long-term adherence is required
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In terms of diet, you should drink more water, be low in purines, ban beer, and control the intake of soy products, thick soup, seafood, and fructose; in terms of exercise, low-intensity aerobic exercise should be the main goal, with weight control as the goal
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If the effect of life>
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Figure 3 "It turns out that the hyperuricemia state is actually the hidden period of gouty arthritis.
Although there are no symptoms in this hidden period, it has actually started to damage many of my organs, and it will lead to gout attacks later
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Then I will start treatment from now on to reduce uric acid one step ahead! I have to tell my friends the news quickly, their previous practices were too irregular! "Acute gout attack needs to be treated, and even more when it doesn't attack! Everyone in front of the phone, do you know how to manage the hidden period of gouty arthritis? Reference: [1] Chinese guidelines for the diagnosis and treatment of hyperuricemia and gout ( 2019)[J].
Chinese Journal of Endocrinology and Metabolism,2020,36(1):1-13.
DOI:10.
3760/cma.
j.
issn.
1000-6699.
2020.
01.
001.
[2]Guidelines for primary diagnosis and treatment of gout and hyperuricemia (2019)[J].
Chinese Journal of General Practitioners,2020,19(4):293-303.
DOI:10.
3760/cma.
j.
cn114798-20200328-00382.
[3]Bardin T.
Impact of comorbidities on gout and hyperuricaemia:an update on prevalence and treatment options.
BMC Med.
2017 Jul 3;15(1):123.
DOI:10.
1186/s12916-017-0890-9.
[4]Liu R.
Prevalence of Hyperuricemia and Gout in China From 2000 to 2014:A Systematic Review and Meta-Analysis.
Biomed Res Int.
2015;2015:762820.
DOI:10.
1155/2015/762820.
Review Expert Li JiaDirector of Endocrinology Department of Southern Theater General Hospital, Doctor of Medicine, Graduate Supervisor Chinese Medicine Deputy Director of the Clinical Endocrine Drug Evaluation Branch of the Education Association Director of the Osteoporosis Prevention and Rehabilitation Committee of the Guangdong Provincial Elderly Health Care Association Youth Member of the Endocrine Branch of the Guangdong Medical Association Deputy Director of the Diabetes Branch of the Guangzhou Medical Association Published more than 40 papers in SCI and core journals Editor-in-chief, co-editing, and translation of 5 monographs.
In recent years, he presided over 5 national natural, provincial and ministerial-level funds, and served as a reviewer for many SCI journals in simultaneous translation of the conference.