|
赵天仪.2025版痛风抗炎症治疗指南解读与临床实践要点[J].内科急危重症杂志,2026,32(2):121-124
|
| DOI：10.11768/nkjwzzzz20260204 |
| 中文关键词: 痛风 炎症 指南 实践 |
| 英文关键词: |
| 基金项目: |
|
| 摘要点击次数: 192 |
| 全文下载次数: 135 |
| 中文摘要: |
| 摘要 痛风是一种以高尿酸血症为基础，单钠尿酸盐晶体沉积驱动的炎症性关节病。反复发作的痛风、炎症反应贯穿疾病全程。长期以来临床管理多以“降尿酸”为核心，而对痛风的抗炎症治疗尚缺乏系统性的指导。2025年11月，由中华预防医学会风湿病预防专业委员会组织多学科专家，基于最新循证证据制订并发布了《痛风抗炎症治疗指南（2025版）》。该指南提出“全程抗炎”框架，并以“评估-分层-决策”模式填补了长期以来“重降尿酸、轻控炎症”的临床短板。本文围绕该指南总结痛风患者抗炎症治疗的基本原则，探讨合并心血管疾病、消化道疾病、慢性肾脏病等痛风患者抗炎症策略，以及痛风石患者长程抗炎管理方案。并在此基础上分析痛风抗炎症管理的临床循证困境，推动痛风领域临床研究的发展。 |
| 英文摘要: |
| Abstract Gout is an inflammatory arthropathy driven by monosodium urate crystal deposition on the basis of hyperuricemia. In patients with recurrent gout, inflammatory responses persist throughout the disease course. Historically, clinical management has centered on urate-lowering therapy, whereas systematic guidance is still lacking for anti-inflammatory treatment of gout. In November 2025, a multidisciplinary panel convened by the Rheumatology Prevention Professional Committee of the Chinese Preventive Medicine Association developed and issued the Guideline for Anti-inflammatory Treatment of Gout (2025 Edition) based on the latest evidence. The guideline proposes a "whole-course anti-inflammation" framework and bridges the long-standing clinical gap of prioritizing urate lowering over inflammation control through an "assessment-stratification-decision" approach. This article summarizes the fundamental principles of anti-inflammatory therapy for gout patients, discusses anti-inflammatory strategies for those with comorbid cardiovascular disease, gastrointestinal disease, and chronic kidney disease, and presents long-term anti-inflammatory management plans for patients with tophi. Building on these discussions, we further analyze evidence-based challenges in clinical anti-inflammatory management of gout, with the aim of promoting the development of clinical research in the field. |
|
|
|
|
