痛风|伴侣Wikawa KaiKōiwi

Gout (mate waikawa kai kōiwi) is a common and painful form of arthritis. It causes severe joint pain and swelling, especially in your toes, knees, elbows, wrists and fingers. If left untreated, gout can cause serious damage to your joints, kidneys and quality of life.


Key points

  1. 痛风是由血液中尿酸堆积引起的。尿酸在关节中形成晶体。
  2. 高尿酸水平主要是由于遗传因素。虽然在毛利人和帕西菲卡(Pasifika)的男人中很常见,但痛风不正常 - 如果您有症状,请参见医生。
  3. If you have more than two attacks of gout per year, your doctor may prescribe a medication to prevent further attacks by lowering your uric acid levels. The key to preventing gout attacks is getting uric acid levels to below 0.36 mmol/L.
  4. 如果未经处理的痛风可能会对您的关节造成永久损害并损害肾脏。
  5. 通过有效的治疗,可以在12-24小时内控制痛风攻击。药物和生活方式的改变可以帮助防止痛风攻击。

What causes gout?

Gout is caused by a buildup of uric acid in your body

  • gout - footUric acid mostly (two-thirds) comes from the breakdown of cells in your body. The remainder (one-third) comes from chemicals called purines that are in your food.
  • Normally, your kidneys filter uric acid from your blood and flush it out of your body in urine (pee).
  • When uric acid levels in your blood are high, uric酸晶体形成your关节。These crystals cause pain, inflammation and lumps (called tophi).

Image: Pixabay

What causes high uric acid?

  • The most common cause of high uric acid is due to your body not getting rid of it properly.
  • 90% of this is due to your genes. Other factors can include certain medications and other health conditions.

Who is at risk of getting gout?

High uric acid levels are caused by the following factors:

  • Genetics- 一些毛利人和帕西菲卡人的基因使从身体中清除尿酸变得更加困难。
  • Being overweight– carrying extra weight slows down the removal of uric acid by your kidneys.
  • 年龄增加– in about 90% of cases, gout affects men aged over 40 years and women after menopause.
  • What you eat and drink– you increase your risk if you drink a lot of sugary drinks or alcohol, or eat too much food that is rich in purines, such as liver, meat or seafood.
  • 高血压(hypertension).
  • Taking certain medicines,例如用于高血压或心力衰竭的水或流体片剂(利尿剂)。阅读更多有关medicines that increase uric acid levels
  • Existing kidney problems和some other conditions.

In people with known gout, there are changes you can make toreduce the risk of developing gout

Tip: Ask your doctor whether you need to change any medications you take for other health problems.

What are the symptoms of gout?

The symptoms of gout include severe pain in one or more joints. In most cases, gout affects one joint at a time.

  • 最常见的关节是大脚趾。其他站点包括您的前脚,脚跟,脚跟,脚踝和膝盖。痛风在上半身并不常见,但它会影响您的手指,手腕和肘部。
  • Gout attacks are very painful. A gout attack usually begins suddenly, often at night. Within hours, the joint becomes red, swollen, hot and painful. This is due to uric acid crystals in the joint causing sudden inflammation.
  • 疼痛和压痛可能是如此严重,即使是床上用品的轻柔压力也是一个问题。即使只有一个小关节受到影响,炎症也可能激烈,以引起发烧,肌肉酸痛和其他类似流感的症状。
  • 攻击通常持续5到10天,但在极少数情况下,它可以持续数周。

How is gout diagnosed?


In the early stages of gout, x-rays are not usually helpful in diagnosis, but in advanced gout x-rays can show any damage to your cartilage and bones.

How are gout attacks treated?

一旦攻击,请立即去看医生。With effective treatment the attack may be controlled within 12–24 hours and treatment need not be continued after a few days. There are also things you can do to help relieve the pain:

  • rest until your symptoms improve
  • raise the inflamed joint and put an ice pack on it
  • 在急性攻击中不要运动
  • take pain relief medicines, for example non-steroidal anti-inflammatory drugs (NSAIDs) such asnaproxen(Naprosyn) ordiclofenac(Voltaren) can be very effective in reducing pain and inflammation. If you are unable to take NSAIDs, medication such ascolchicine或者强的松can help reduce the pain of gout.
  • 为了获得最佳效果,请在攻击的第一个迹象时尽快采取NSAID,并继续直到疼痛和肿胀下降为止。

阅读更多有关medicines for gout


If gout is not treated, it can cause permanent damage to your joints and harm your kidneys. Attacks will happen again and more joints will be affected. Lumps (tophi) can grow on your elbows, hands and feet. The lumps can become sore and swollen and they may cause skin ulcers. The natural padding between the bones will start to wear away and the joints will become sore and stiff. Kidney stones can form and cause pain and damage to your kidneys.

Preventing gout attacks

To prevent gout attacks and damage to your joints, your doctor may start you on long-term gout medication, called urate lowering medicines. They are most likely to do this if you:

  • 每年进行两次或多次痛风攻击
  • already have evidence of damage from gout on joint x-rays
  • have tophi, chronic kidney disease or kidney stones.


降低尿酸药物降低身体的尿酸水平。这些药物的例子是allopurinol,概率,benzbromaronefebuxostat。别嘌醇is most commonly used.

  • The aim of these medicines is too keep your uric acid level below 0.36 mmol/L. This will help to prevent gout attacks, joint damage and kidney stones and will make your gouty lumps smaller.
  • You need to take uric acid medicines every day, even if you are having a gout attack.
  • 当您开始服用降低尿酸medicine you might get a gout attack, as your body is getting rid of the extra uric acid. Your doctor will prescribe additional medication such as a low-dose非甾体类抗炎(NSAID)或者colchicineto reduce the chances of these attacks.

阅读更多有关medicines for gout

Lifestyle changes

  • 超重会增加痛风的风险 - 携带额外的体重会减慢肾脏去除尿酸的速度。如果您超重,逐渐减肥可以帮助降低尿酸水平并降低痛风攻击的风险。
  • Cutting out sweetened foods and drinks from your diet and avoiding eating too much food high in purines can help to prevent gout attacks.

阅读更多有关痛风的饮食和减肥5 steps you can take to prevent gout

Learn more

Are you at risk of gout?Workbase Education Trust
Out with goutPharmac, NZ


  1. An update on the management of goutBPAC, NZ 2013
  2. A conversation about goutBPAC,2014年
  3. Winnard D,Wright C,Jackson G,Gow P,Kerr A,McLachlan A,Orr-Walker B,Dalbeth N. Gout,Aotearoa新西兰成年人的糖尿病和心血管疾病NZ Med J. 2012年1月25日; 126(1368):53-64。[抽象的][Full article]
  4. Batt C, Phipps-Green AJ, Black MA, et al. Sugar-sweetened beverage consumption: a risk factor for prevalent gout with SLC2A9 genotype-specific effects on serum urate and risk of gout Ann Rheum Dis 2014;73:2101–2106 [abstract][完整的PDF]
Credits: Editorial team. Reviewed By: Professor Lisa Stamp, Rheumatologist, University of Otago Christchurch 上次审查:2018年5月3日