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严格忌口，为什么尿酸不降反升呢？

2021-10-04 风湿新前沿 MedSci原创

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每一位痛风患者听到最多的恐怕就是，海鲜少吃，红肉少吃……一定要管住嘴！

每一位痛风患者听到最多的恐怕就是，海鲜少吃，红肉少吃……一定要管住嘴！

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可是明明已经很严格的控制饮食了，每天只吃草，脸都吃绿了。

 

为什么尿酸没有降下去，反而变高了呢？
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且听小编慢慢道来……拿起小本本记起来吧
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痛风形成的原因

血液中的尿酸水平长期在饱和点以上，这就会导致尿酸形成结晶后并沉积在脚、膝盖、手和肘部的外周关节，尤其是受骨关节炎影响的关节。
 
而这一切都发生的悄无声息，患者基本上察觉不到，沉积的尿酸晶体逐渐增加。
 
直到有一天，尿酸盐晶体从关节软骨脱落到关节间隙，这就会引发急剧的难以忍受的剧痛。
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如果患者不及时治疗，尿酸盐结晶会继续沉积，不仅会导致进一步的急性发作，而且其他的关节部位，也有可能被破坏。
 
甚至可能导致不可逆的关节损伤甚至是残疾！
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我们知道了导致痛风的罪魁祸首就是血液中过高的尿酸。
 
那尿酸是从何处来，又去往何处呢？
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让我们一起详细的看一看尿酸在体内的形成与代谢过程吧！
 
总的来说，高嘌呤食物和肥胖都会产生大量的嘌呤。
嘌呤分布在我们的血液和组织中。
最后，再经由肠道和肾脏代谢出去。
 
图片
图片中的红色的尿酸池，他就像一滩流动的池水，只有当“进”和“出”保持一个合理的动态的平衡中，水池中的水才不会溢出来。我们的尿酸才不会形成结晶。
 
所以控制尿酸和剁手是一样的，要“节源”和“开流”。
图片

 

关于节源

 
首先就是要控制饮食。
少食富含嘌呤的饮食—肝脏、野味、凤尾鱼、沙丁鱼和肉汁等，来源于饮食的嘌呤约占嘌呤总量的30%。
第二点是很多人不知道的原因，那就是——肥胖。
来源于身体组织的核苷酸代谢产生约70%的嘌呤。肥胖不仅增加了嘌呤的产生量，体内的脂肪还会抑制尿酸的排出。
图片

 

关于开流

 

尿酸排泄效率低下，体内的高尿酸不能够及时的排除体外导致尿酸沉积。

 

什么因素会影响尿酸的代谢呢？
1. 利尿剂（水潴留缓解剂）或肾功能不全（肾脏无法过滤废物）降低肾脏排泄尿酸的能力。体内70%的尿酸通过肾脏排出，其余30%通过肠道排出。
 
2. 遗传倾向导致一些人肾脏排泄尿酸的效率相对较低。
 
3. 代谢综合征，比如高血压、胰岛素抵抗和高脂血症。胰岛素抵抗会导致肝脏合成脂肪酸增加，嘌呤代谢增加，从而升高尿酸水平。在25%-60%的痛风患者中具有高脂血症。
 
4. 饮酒过量。代谢酒精需要大量的三磷酸腺苷即ATP，ATP代谢后生成腺嘌呤核苷酸成为尿酸合成的原料。此外，肾脏排泄也会因酒精代谢产生的乳酸受到抑制。
 
5. 甲状腺功能减退症
6. 免疫抑制药物
7. 服用烟酸或维生素 B-3
8. 银屑病
9. 肿瘤溶解综合征（由某些癌症或这些癌症的化疗引起的细胞快速释放到血液中）
……
所以想要控制尿酸水平绝不止是简单的控制饮食这么简单。如果已经严格控制了饮食，尿酸还是没有降下来就要考虑是不是因为其他原因，例如：肥胖，肾功能不全，代谢异常等原因。

如何降尿酸

 

患者首先要改善生活方式。如果超重或肥胖，应该采取健康的方式减轻体重。

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减少啤酒和烈酒的过量摄入
 
减少过量摄入富含嘌呤的食物（如红肉和海鲜）并按比例摄入更多乳制品
减少富含果糖的饮料和水果（苹果、橙子）的摄入
 
停止任何视黄醇补充剂（与β-胡萝卜素相比，视黄醇会增加血清尿酸水平，β-胡萝卜素则会降低尿酸）。
 
最后！一定要配合医生的治疗方案，按时回访、定期复查尿酸水平。
 
一旦身体有任何异样或者不舒服的情况，请及时联系自己的主治医生。
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最后，祝大家都有一个好身体和好心情！

 

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    2023-06-07 ms5000000082881372 来自内蒙古

    好喜欢这种风格的分享

    0

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    2021-10-08 gqylhd

    患教的好素材

    0

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    2021-10-05 ms5000000082881372

    学习了

    0

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    2021-10-04 ms4000001623577859

    学习了

    0

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    2021-10-04 ms5000000620284271

    受教

    0

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    2021-10-04 严加琴

    开源节流

    0

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    2021-10-04 李晓红

    尿酸高易患痛风

    0

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    2021-10-04 CarolMemphis

    开源节流

    0

  9. [GetPortalCommentsPageByObjectIdResponse(id=2141323, encodeId=653d214132353, content=好喜欢这种风格的分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=62, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c0775455177, createdName=ms5000000082881372, createdTime=Wed Jun 07 21:48:51 CST 2023, time=2023-06-07, status=1, ipAttribution=内蒙古), GetPortalCommentsPageByObjectIdResponse(id=1058493, encodeId=aa3f1058493b9, content=患教的好素材, beContent=null, objectType=article, channel=null, level=null, likeNumber=93, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c3c31528806, createdName=gqylhd, createdTime=Fri Oct 08 00:14:39 CST 2021, time=2021-10-08, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057896, encodeId=de07105e896f0, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=117, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c0775455177, createdName=ms5000000082881372, createdTime=Tue Oct 05 15:04:35 CST 2021, time=2021-10-05, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057714, encodeId=4f67105e714c0, content=学习了, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=9ba65625470, createdName=ms4000001623577859, createdTime=Mon Oct 04 23:27:45 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057694, encodeId=443d105e694d6, content=受教, beContent=null, objectType=article, channel=null, level=null, likeNumber=82, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=66aa5625439, createdName=ms5000000620284271, createdTime=Mon Oct 04 22:30:23 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057684, encodeId=0f23105e68470, content=开源节流, beContent=null, objectType=article, channel=null, level=null, likeNumber=132, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://q.qlogo.cn/qqapp/1103841572/F6C250BEC917CB66E8C40416112FC5F5/100, createdBy=71152038442, createdName=严加琴, createdTime=Mon Oct 04 21:45:56 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057678, encodeId=7c69105e678e2, content=尿酸高易患痛风, beContent=null, objectType=article, channel=null, level=null, likeNumber=59, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/vyAkV8zQqYbLSIGQRrZmSqLvwibFDXpiaOuvIibCUFSwLp2ID4nTOupHSU2ygjh7vUqoibglOLZwQrrF8SdchMVIibg/132, createdBy=02b72465928, createdName=李晓红, createdTime=Mon Oct 04 21:36:52 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057589, encodeId=a967105e58936, content=开源节流, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=/v1.0.0/img/user_icon.png, createdBy=39ac5563372, createdName=CarolMemphis, createdTime=Mon Oct 04 14:57:47 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057462, encodeId=8944105e4623f, content=受教了, beContent=null, objectType=article, channel=null, level=null, likeNumber=90, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=16bd5625091, createdName=ms8000001445948884, createdTime=Mon Oct 04 13:22:20 CST 2021, time=2021-10-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1057461, encodeId=ad21105e46109, content=明白了, beContent=null, objectType=article, channel=null, level=null, likeNumber=81, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://img.medsci.cn/20211003/654ed1437f2448e1a216d4879881112d/0a1b2ce6cf00404481aeb7624a369ba3.jpg, createdBy=ef0c5500374, createdName=ms6000000755639610, createdTime=Mon Oct 04 13:17:20 CST 2021, time=2021-10-04, status=1, ipAttribution=)]
    2021-10-04 ms8000001445948884

    受教了

    0

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    2021-10-04 ms6000000755639610

    明白了

    0

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