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中华肥胖与代谢病电子杂志 ›› 2026, Vol. 12 ›› Issue (01) : 38 -43. doi: 10.3877/cma.j.issn.2095-9605.2026.01.006

综述

尿酸盐沉积相关非典型痛风临床表现研究进展
刘学亮, 聂深钰, 段晓晓, 武树朋, 陈东育()   
  1. 271000 泰安,泰安市中心医院 风湿免疫科
  • 收稿日期:2025-04-23 出版日期:2026-02-28
  • 通信作者: 陈东育

Research progress on clinical manifestations of atypical gout related to urate deposition

Xueliang Liu, Shenyu Nie, Xiaoxiao Duan, Shupeng Wu, Dongyu Chen()   

  1. Department of Rheumatology and Immunology, Taian Central Hospital (The Affiliated Taian Central Hospital of Qingdao University, Mount Taishan Medical and care center), Taian, 271000, China
  • Received:2025-04-23 Published:2026-02-28
  • Corresponding author: Dongyu Chen
引用本文:

刘学亮, 聂深钰, 段晓晓, 武树朋, 陈东育. 尿酸盐沉积相关非典型痛风临床表现研究进展[J/OL]. 中华肥胖与代谢病电子杂志, 2026, 12(01): 38-43.

Xueliang Liu, Shenyu Nie, Xiaoxiao Duan, Shupeng Wu, Dongyu Chen. Research progress on clinical manifestations of atypical gout related to urate deposition[J/OL]. Chinese Journal of Obesity and Metabolic Diseases(Electronic Edition), 2026, 12(01): 38-43.

尿酸盐沉积除可引发典型关节痛风外,亦可累及皮肤软组织、肌腱、头颈部、脊柱胸廓及内脏血管等多系统,临床可呈无痛结节、蜂窝织炎样炎症、肿瘤或感染样占位、神经压迫症状等非特异表现,且部分患者就诊时血尿酸并不升高,易致漏诊与误诊。结晶学/病理学证实仍为确诊依据,但特殊部位取材受限,传统影像对部分关节外病灶提示有限。双能CT可较特异识别并量化尿酸盐沉积,在脊柱与内脏等部位的定位及鉴别中具有价值,但早期敏感性与伪影假阳性需关注。本文围绕尿酸盐沉积致病的非典型表型,总结其临床特征、影像学要点及诊治思路,以期提高临床识别能力、减少误诊漏诊,并为后续规范化管理与研究提供参考。

The prevalence of gout in China is increasing year by year, and it shows a trend of youthfulness. Uric acid can not only be deposited in common joints, causing classic gout attacks, but also widely deposited in various parts of the body, showing atypical pathogenic manifestations. Many reasons, such as atypical clinical manifestations, special location, special population, lack of clinical understanding, and cover-up of comorbidity, have greatly increased the difficulty of clinical diagnosis and treatment, and the probability of clinical missed diagnosis and misdiagnosis is high, which deserves the attention of clinicians. Traditional imaging examination has limited diagnostic value. Dual-energy computed tomography (DECT) can specifically identify urate crystals, which is helpful for diagnosis. Through literature review, this paper summarizes the atypical clinical manifestations of uric acid deposition, and provides reference for clinical diagnosis and treatment.

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