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class="lh34 wbwr f16 fc9">問題描述：</div> <div id="snqh4nb" class="lh32 wbwr f16">如何區(qū)分類風濕性關(guān)節(jié)炎與痛風</div> </div> <!-- 全部回答 --> <h3 class="fn f28 bb1 lh36 pt10 pb15 posr" data-ruleid="BsHmDY">全部回答<div id="prxaiav" class="f14 fc9 right-bottom-count">共<span id="q44kzgm" class="blue">1</span>條回答</div></h3> <div id="wdwwvq4" class="posr all-answer-list pt20 pb20"> <div id="pi44pvf" class="img ovh"> <img class="all-img" src="https://file.bohe.cn/fhfile1/M00/07/78/oYYBAGJ51SuADe8qAABzmzUUXwA41.jpeg" alt="王燕"> </div> <h5 class="fn f14 fc9 h5 mb10"> <span id="yuxgti4" class="mr10">王燕</span> <span id="91jd9k9" class="mr10">鄭州大學第五附屬醫(yī)院</span> <span id="akj6ed9" class="mr10">主任醫(yī)師</span> <!-- <span id="jhmoc9q" class="mr10">腎病風濕科</span> --> <time class="flr">回答時間：2025-05-06 20:21</time> </h5> <div id="bs9pkjh" class="f16 lh28 wbwr des"> <div>風濕性關(guān)節(jié)炎與痛風的區(qū)分主要通過癥狀差異、發(fā)病原因、常見部位和實驗室檢查來判斷。兩者都屬于關(guān)節(jié)疾病，但病因和表現(xiàn)各不相同，治療方案也有針對性。<br>1、發(fā)病原因與特征對比<br>風濕性關(guān)節(jié)炎是一種自身免疫性疾病，主要是因為免疫系統(tǒng)攻擊自身關(guān)節(jié)組織導致炎癥和關(guān)節(jié)損害，其確切原因尚不完全明確，但遺傳、吸煙、感染等因素可能參與。痛風則主要由于長期尿酸水平過高，導致尿酸鹽結(jié)晶沉積于關(guān)節(jié)引發(fā)劇烈疼痛。痛風通常與飲食、酒精攝入過量及腎功能等有關(guān)。<br>建議：風濕性關(guān)節(jié)炎患者應(yīng)避免感染、壓力等誘因，定期用藥減少免疫反應(yīng)。痛風患者需減少高嘌呤食物如海鮮、動物內(nèi)臟攝入，并多喝水促進尿酸排泄。<br>2、常見病變部位<br>風濕性關(guān)節(jié)炎常見于雙手、雙膝及腳踝等較小關(guān)節(jié)，且發(fā)生對稱性；病程長易造成關(guān)節(jié)畸形。痛風則多見于大腳趾根部，單側(cè)發(fā)作更為常見，病程以急性發(fā)作為特征，會出現(xiàn)紅腫熱痛癥狀。<br>建議：風濕性關(guān)節(jié)炎患者可通過抗風濕藥如甲氨蝶呤緩解癥狀，痛風患者急性期可使用秋水仙堿或非甾體抗炎藥快速止痛。<br>3、輔助檢查的診斷依據(jù)<br>風濕性關(guān)節(jié)炎可通過血液檢查檢測抗環(huán)瓜氨酸肽抗體CCP抗體，合并類風濕因子RF的陽性率。X光甚至MRI可顯示關(guān)節(jié)的退變。痛風則需通過血尿酸水平審查，以及關(guān)節(jié)液中是否存在尿酸鹽結(jié)晶。<br>建議：風濕性關(guān)節(jié)炎需定期復查關(guān)節(jié)狀態(tài)，使用免疫抑制劑管理病情。痛風患者需控制尿酸水平，可服用別嘌呤醇或非布司他。<br>風濕性關(guān)節(jié)炎的本質(zhì)是免疫系統(tǒng)攻擊關(guān)節(jié)組織，而痛風則是尿酸水平異常所致。如果自身癥狀無法判斷，及時就醫(yī)借助醫(yī)生的專業(yè)診斷和實驗室檢查，是精確區(qū)分和正確治療的首要步驟。</div> 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