痛风|痛风治疗，首选别嘌醇、苯溴马隆还是非布司他？( 二 )
痛风急性发作期过后立即停秋水仙碱？
秋水仙碱、非甾体消炎药等抗炎止痛药可以控制痛风急性发作的症状，但有些患者担心副反应，一旦痛风急性症状控制后即停用秋水仙碱，试图单靠降尿酸药物来预防痛风发作，这个做法其实是不对的 。
我们知道血尿酸发作频率跟血尿酸的水平有关，而在降尿酸盐治疗的最初几个月里痛风相对容易频繁复发，这是由于血尿酸的过快下降和波动易带来痛风发作 。因此推荐联合秋水仙碱来预防痛风发作，如血尿酸达目标值则可以停秋水仙碱 。
编辑｜于昉 伏地羊
参考资料：
1 中国高尿酸血症与痛风诊疗指南(2019)
2. Food Sources of Protein and Risk of Incident Gout in the Singapore Chinese Health Study[J].Arthritis Rheumatol. 2015;67(7):1933.
3. Colchicine for prophylaxis of acute flares when initiating allopurinol for chronic gouty arthritis[J].J Rheumatol. 2004;31(12):2429.
4. Uric acid and survival in chronic heart failure: validation and application in metabolic, functional, and hemodynamic staging[J].Circulation. 2003 Apr 22;107(15):1991-7. Epub 2003 Apr 21.
5. Association of serum uric acid and cardiovascular disease in healthy adults[J].Am J Cardiol. 2013;111(8):1146. Epub 2013 Jan 24.
6. Significance of serum uric acid levels on the risk of all-cause and cardiovascular mortality[J].Rheumatology (Oxford). 2013;52(1):127. Epub 2012 Aug 25.
7. Effect of allopurinol in chronic kidney disease progression and cardiovascular risk[J].Clin J Am Soc Nephrol. 2010;5(8):1388. Epub 2010 Jun 10.
8.Efficacy of Febuxostat for Slowing the GFR Decline in Patients With CKD and Asymptomatic Hyperuricemia: A 6-Month, Double-Blind, Randomized, Placebo-Controlled Trial[J]. Am J Kidney Dis 2015; 66:945.
9. Allopurinol improves endothelial dysfunction in chronic heart failure[J].Circulation. 2002;106(2):221.
10. Transient reduction in myocardial free oxygen radical levels is involved in the improved cardiac function and structure after long-term allopurinol treatment initiated in established chronic heart failure[J].Eur Heart J. 2005;26(15):1544. Epub 2005 May 4.
11. A benefit-risk assessment of benzbromarone in the treatment of gout. Was its withdrawal from the market in the best interest of patients?[J].Drug Saf. 2008;31(8):643-65.
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