[[alternative]]Related Factors of Serum Uric Acid Concentration among Post-treatment Gouty Patients

[[abstract]]背景：近年來，不論在國內外痛風與高尿酸血症均有日益增加的趨勢。先前有研究指出痛風的治療成效不只是要關心痛風發作次數、痛風石生成以及痛風石狀態，其中控制血中尿酸濃度是痛風治療的重要指標，目前仍缺少治療後血中尿酸值影響因素相關文獻的探討。本研究旨在探討影響治療後血中尿酸濃度的因素，從對病患的照顧治療，更進一步地推廣至預防，以及協助預後教育的推動與病情的控制。目的：1.瞭解痛風病患就醫治療後，血中尿酸濃度的控制情形。2.探討治療中痛風病患血中尿酸濃度的影響因素。材料：研究樣本取自宏恩醫院痛風科門診病患，經審查資料完整性，最後樣本為1,862人。方法：複迴歸技術進行治療後血尿酸值的相關因素分析。結果：所有樣本的治療後平均血清尿酸值是6.76±2.03 mg/dl，其中男性的平均血清尿酸值為6.78±2.04 mg/dl，而女性平均血清尿酸值為6.23±1.80 mg/dl；治療後血清尿酸濃度以6 mg/dl以下的佔41.4%為最多，6-8 mg/dl佔34.9%居次，8 mg/dl以上的有23.7%。整體模式可解釋治療後血中尿酸濃度12.4%的變異，統計上顯著相關的變項包括年齡、肥胖、血清肌酸酐、酒精攝取量、抽菸量、一年內未按時到診月數；其他變項如性別、高血壓病史、糖尿病病史、工作情形、睡眠情形與自覺睡眠品質則無顯著差異。討論：痛風病患如能適量運動減輕體重、控制血清肌酸酐值、減少喝酒量與抽菸量，其中最重要的是遵從醫師醫囑，定期回診，按時服用降尿酸藥物，就能有效降低血中尿酸值。[[abstract]]Background: The prevalence of gout and hyperuricaemia are on the increase in both domestic and foreign countries in recent years. In previous studies, the outcome of gouty patients was mainly focused on the frequency of gouty attack within last one year, formation of tophus, and tophus condition, and the control of serum uric acid level was indicated to be an important parameter for good outcome of gout. Therefore, the purpose of this study is to analyze the related factors of serum uric acid level among gouty patients after medical treatment.Objectives: To analyze the serum uric acid concentration and its related factors among post-treatment gouty patients.Data source: The data of this study were collected from the outpatient department of the Gout Clinic at Country Hospital. There were 1,862 gouty patients included in this study.Methods: Study variables were analyzed and examined with multiple regression analysis.Results: The mean UA value for all subjects was 6.76±2.03 mg/dl, and that for male and female gout were 6.78±2.04 and 6.23±1.80 mg/dl, respectively. There were 41.4 % of the cases with UA controlled under 6 mg/dl, 34.9 % between 6 to 8 mg/dl, and 23.7 % over 8 mg/dl. The full model could explain the 12.4 percent degree of variation. Age, obesity, creatinine, alcohol consumption, smoking and number of months of absence from continuous clinical visit were significantly correlated with UA levels, however, the other variables such as gender, hypertension, diabetes mellitus, time of working, time and perceived quality of sleep were not significantly correlated with UA levels.Conclusions: To take exercise and to lose weight, control serum creatinine, reduce drinking and smoking, comply with doctor’s advice, visit the doctor on time, and take a regular medical care may all help controlling serum uric acid levels for gouty patients