痛风,The Lancet

痛风是一种常见的和可治疗的疾病，由尿酸单钠晶体在关节和非关节结构中沉积引起。血清尿酸盐（高尿酸血症）浓度升高是痛风发展的最重要危险因素。血清尿酸盐受肾脏和肠中尿酸盐转运蛋白的调节，尤其是GLUT9（SLC2A9），URAT1（SLC22A12）和ABCG2。尿酸单钠晶体对NLRP3炎性小体的激活和IL-1β的释放在痛风发作的发生中起主要作用。聚集的嗜中性粒细胞胞外捕集器在拆分阶段很重要。尽管表现为间歇性扩张，但痛风是一种慢性疾病。长期降低尿酸水平的疗法（例如别嘌醇）会导致尿酸单钠晶体的溶解，最终导致预防痛风发作和痛风石病，并改善生活质量。诸如护士指导的护理之类的策略可以有效地提供高质量的痛风护理，并可以显着改善患者的预后。

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Gout is a common and treatable disease caused by the deposition of monosodium urate crystals in articular and non-articular structures. Increased concentration of serum urate (hyperuricaemia) is the most important risk factor for the development of gout. Serum urate is regulated by urate transporters in the kidney and gut, particularly GLUT9 (SLC2A9), URAT1 (SLC22A12), and ABCG2. Activation of the NLRP3 inflammasome by monosodium urate crystals with release of IL-1β plays a major role in the initiation of the gout flare; aggregated neutrophil extracellular traps are important in the resolution phase. Although presenting as an intermittent flaring condition, gout is a chronic disease. Long-term urate lowering therapy (eg, allopurinol) leads to the dissolution of monosodium urate crystals, ultimately resulting in the prevention of gout flares and tophi and in improved quality of life. Strategies such as nurse-led care are effective in delivering high-quality gout care and lead to major improvements in patient outcomes.