基础医学与临床 ›› 2025, Vol. 45 ›› Issue (11): 1485-1490.doi: 10.16352/j.issn.1001-6325.2025.11.1485

• 临床研究 • 上一篇    下一篇

24例肩部关节痛风患者的临床特点

王一博, 韩迎东, 谢天歌, 武娟, 狄虹, 张昀*, 曾学军   

  1. 中国医学科学院 北京协和医学院 北京协和医院 全科医学科(普通内科),北京 100730
  • 收稿日期:2025-06-30 修回日期:2025-09-15 出版日期:2025-11-05 发布日期:2025-10-24
  • 通讯作者: *zhangyun10806@pumch.cn
  • 基金资助:
    协和人才培育支持计划C类项目(UBJ10806);中央高水平医院临床科研专项(2022-PUMCH-B-044)

Clinical characteristics of gout patients with shoulder joints involved from 24 cases

WANG Yibo, HAN Yingdong, XIE Tiange, WU Juan, DI Hong, ZHANG Yun*, ZENG Xuejun   

  1. Department of General Internal Medicine, Peking Union Medical College Hospital, CAMS & PUMC,Beijing 100730, China
  • Received:2025-06-30 Revised:2025-09-15 Online:2025-11-05 Published:2025-10-24
  • Contact: *zhangyun10806@pumch.cn

摘要: 目的 总结肩部关节痛风患者的临床特点,以期提高对该组患者的认识。方法 纳入2021年3月至2025年4月北京协和医院痛风门诊及全科医学科(普通内科)病房诊治的24例肩部关节受累的痛风患者,以及经病程、性别匹配的70例肩部关节未受累的痛风患者对照。收集其病史资料、辅助检查结果、治疗方案和转归,比较总结其临床特点。结果 24例肩部关节受累的患者均为男性,平均年龄(43.16±13.13)岁,平均体质量指数(27.70±4.63) kg/m2,痛风病程8(5, 12)年,就诊前平均最高血尿酸为(754.15±175.79) μmol/L。16.67%的受累患者无症状,79.17%表现为肩部疼痛,25.00%出现皮下痛风石。所有患者均处于慢性痛风性关节炎期,腕关节、手指关节和肘关节受累更加显著(P<0.05),受累关节由下肢进展至上肢的时间为(4.72±2.80)年。该组患者血尿酸负荷更高(P<0.05),而血肌酐和C反应蛋白则无统计学意义。结论 肩部关节受累的痛风患者年龄更大,症状不典型,诊断更依赖影像学或关节穿刺。

关键词: 痛风, 肱盂关节, 肩锁关节, 关节穿刺

Abstract: Objective To characterize the clinical features of the group of gout patients to facilitate earlier identification, and optimize the diagnosis and treatment of the condition. Methods The retrospective study analyzed 24 gout patients with shoulder joint(s) involved and consulted by physicians of Peking Union Medical College Hospital from March 2021 to April 2025, while 70 outpatient gout patients matched by clinical course duration and sex were enrolled as control group. Clinical data including medical history, laboratory tests, therapeutic interventions. Prognosis was systematically collected to delineate the distinctive clinical manifestations of the patients. Results All 24 gout patients with shoulder joints involved were male, aged (43.16±13.13)years and had an average BMI of 27.70±4.63. The duration of gout was 8(5,12) years while of those patients had an early onset before 30 years old. The maximal serum uric acid concentration was (754.15±175.79) μmol/L. It was shown by case review that 16.67% of the patients were asymptomatic, and 79.17% suffered from shoulder pain. A quarter of the patients developed subcutaneous tophi. All the patients affected (P<0.05). The affected joints ascended from lower extremities to the upper averagely took 4.72±2.80 years and had heavier burden of hyperuricemia (P<0.05), while no significant difference was found in renal function and inflammation level. Conclusions Gout patients with shoulder joints involvement are older and have atypical manifestation. The diagnosis needs support of imaging or arthrocentesis.

Key words: gout, glenohumeral joint, acromioclavicular joint, arthrocentesis

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