一. 什麼是高尿酸血症:
高尿酸血症與體內普林的代謝過程異常有關。普林來自於身體內的合成,組織中核酸的分解或是食物中的核蛋白,它經由肝臟代謝形成尿酸後由腎臟排出體外,當每100毫升血液中的尿酸值男性大於7毫克以上, 女性大於6毫克以上 時,稱為高尿酸血症。
二. 造成高尿酸血症的原因:
1.攝取富含普林或導致普林合成增加的食物。如下:
※1.發芽豆類、豆苗、黃豆、黃豆芽、盧筍、紫菜、香菇。
※2.動物內臟:雞肝、雞腸、鴨肝、豬肝、豬小腸、牛肝等。
※3.魚類:白鯧魚、鰱魚、司目魚、吳郭魚、四破魚、白帶魚、烏魚鯊魚、海鰻、沙丁魚、吻仔魚、小魚干、扁魚干。
※4.肉汁、濃肉湯、雞精、酵母粉等。
2.尿酸的合成增加。
3.腎臟排除尿酸受阻。
三.長期高尿酸血症可能引起的問題:
痛風性關節炎、尿路結石、腎臟病、腸並有高脂血症、糖尿病及心臟血管疾病。
四. 痛風與高尿酸血症的關係:
痛風是指當患有高尿酸症時,導致尿酸鈉鹽沉積於血液與組織中。
若沉積在關節腔內就會造成關節紅腫、疼痛和變形。根據文獻報告:羅患痛風的機率會隨著血液中尿酸濃度的身高而顯著增加。
五. 誘發急性痛風的因素:
外傷、手術、出血、感染、放射線治療、藥物、飲酒、暴飲暴食或飢餓等均會使痛風發作。
六. 痛風的臨床徵狀分為四個階段:
1. 無症狀的高尿酸血症。
2. 急性痛風性關節炎。
3. 不發作期。
4. 痛風石及慢性關節炎。
七. 高尿酸血症與痛風患者之注意事項:
1.平時應力求飲食均衡並避免食用普林含量過高的食物,如:內臟類、魚肉類、胚芽及乾豆類等,且每餐肉類(豬、雞、鴨、魚、海產、 黃豆製品) 以二份為原則。
2. 在正常情形下依理想體重每人每天每公斤以攝取1公克蛋白質為宜,應避免攝取過量蛋白質及暴飲暴食。
3.避免攝取食肉湯或肉汁(因為經過長時間亨調得肉湯或肉汁通常含有大量容出的普林)。
4.烹調食用油要適量,少吃油炸食物及避免經常外食。
5.應盡量多喝水,每日至少應飲2000cc以上的水份,以幫助尿酸排泄,可可、咖啡、茶的代謝物不會堆積在組織內,適量的飲用可提高攝水量,架術尿酸排泄。
6.避免喝酒因其在體內代謝產生的乳酸會影響尿酸排泄,促使痛風發作;有其在應酬大魚大肉又喝酒後,最容易引起痛風發作。
7.食慾不佳時要補充糖液體,以避免身體組織快速分解,抑制尿酸排泄誘發痛風。
8.維持標準體重。體重過重時應慢慢減重,每月減重一公斤為宜以免組織快速分解產生大量普林,而引起急性發作,急性發病期不宜減重。
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