Gout has become a common arthritic disease in daily life, and hyperuricemia is closely related to gout, a mechanism based on abnormal purine metabolism, which leads to the deposition of urate crystals, causing an inflammatory response in acute gouty arthritis. For gout**, it is necessary to control inflammation in the acute phase and adhere to long-term uric acid lowering**.
After suffering from gout, why should you care if you have hyperuricemia due to excessive uric acid production or under-excretion? Shouldn't we be concerned first about an acute gouty arthritis attack caused by alcohol consumption or overeating?
In fact, for patients with gout, it is self-evident for gout to judge whether uric acid is due to the problem of production or excretion, especially in terms of using drugs to lower uric acid, it is necessary to treat the symptoms according to the cause of hyperuricemia, so as to achieve the effect of lowering uric acid.
How can you tell if gout is due to excessive uric acid production or impaired excretion?
The pathological mechanism of gout is not single, and the increase in uric acid level caused by abnormal purine metabolism is one of the pathologies, but not all gouts are ** here.
There are two main pathological mechanisms of gout, one is overproduction, which is mainly caused by the body's purine metabolism disorder. When the body's nucleic acid metabolism is enhanced, the purine base in the body is synthesized too much or degraded too quickly, resulting in the disorder of purine metabolism and the increase of metabolites, the production of uric acid will be greatly increased, and over time, urate will form crystals to accumulate and precipitate in the body, and then induce the appearance of gout.
Another pathological mechanism is the impaired excretion of uric acid. This disorder will directly affect the level of uric acid in the body, whether it is in the urine or in the blood, it cannot be excreted normally, and uric acid will accumulate in the body and induce the appearance of gout.
The key to a disease is the cause, so it is especially important to find out accurately, and the same is true for gout. So how should patients self-identify the two most advanced mechanisms of gout?
In general, the most conventional and accurate method is to identify by the amount of uric acid excreted. The method is mainly to measure the excretion of uric acid under the premise of normal diet and no medication. If uric acid excretion exceeds 800 mg, it can be roughly determined that gout is caused by excessive uric acid production. In addition to being identified by the amount of uric acid excreted, it can also be identified by measuring the ratio of the amount of uric acid in the urine to creatinine at will**, if so1A 0 is a hyper-uric acid type, < 05 is the excretory disorder type.
There are usually two possibilities for patients with gout to have too much uric acid:
Caused by enhanced nucleic acid metabolism, that is, excessive purine base synthesis or rapid degradation caused by various reasons, and excessive purine metabolites, resulting in an increase in blood uric acid.
60-70% of the uric acid in the body is excreted through urine, and the rest is excreted through feces, etc., usually such patients due to the decreased uric acid excretion function of the kidneys, resulting in high blood uric acid levels.
How can you tell which type you are?
According to the recommendations of the American Association of Family Physicians, it is more accurate to say that if the uric acid excretion exceeds 800 mg within 24 hours under the condition of normal diet and no medication, it can basically be determined that it is a hypergenic type.
If you find it troublesome, there are also 3 other methods mentioned on the domestic Internet, especially method 3 and method 4 only need to take urine once, which is very simple, but Lao Zhang consulted two foreign doctors, and foreign countries usually prefer the method 1 mentioned above.
Urine was collected for 60 minutes and the midstream urine was retained. At the same time, blood was collected to measure blood uric acid, and the ratio of uric acid excretion per minute to serum uric acid value was calculated, and the normal range was 66～12.6 ml min. cua>12.6 ml genus generation overtype, < 6A 6ml fraction can be judged to be a reduced excretion type.
CUA CCR 100, if 10 is hypergenic, <5 is hypoexcretion. Voluntary urine was significantly positively correlated with 24-hour urine CUA CCR, so a simple one-time urine calculation method can be used in the outpatient setting.
Measuring the uric acid to creatinine ratio in voluntary urine is the easiest way to do thiso genus hypergenic type, < 05. It can be judged as a reduced excretion type.
No matter what kind of gout is caused, patients should pay attention to dietary taboos on weekdays, drink more water, exercise more, control their weight within the normal range, and maintain a positive and optimistic attitude to deal with the disease, which is the best attitude to fight against the disease!