Risk Facors And Treatment In Gout Attack Induced By Proton Pump Inhibitors Treating UGIB

Objective:Explore the risk factors of inducing acute gouty arthritis attack in using proton pump inhibitor therapy for upper gastrointestinal bleeding patients with a history of gout, and compare the efficacy and safety of non-steroidal anti-inflammatory drugs and colchicine for acute gout.Material and Methods:Retrospective analysis the clinical data of 65 cases of upper gastrointestinal bleeding patients with a history of gout. To explore the high risk factors of acute gout arthritis, characteristics including basic disease history, upper gastrointestinal bleeding severity, blood biochemical indexes prior to the gout attack(uric acid, creatinine and urea nitrogen, total cholesterol, triglyceride), blood transfusion therapy and the use of proton pump inhibitor type and dose were analyzed. According to the use of anti gout drug, these patients with acute gout arthritis were divided into two groups, one group using oral nonsteroidal anti-inflammatory drugs(NSAIDs) treatment, the other using NSAIDs combined with low-dose colchicine treatment, and then compare the efficacy and safety.Rerults: In these upper gastrointestinal bleeding patients with a gout history, 42 cases(64.6%) had acute gout attack. Univariate analysis showed that blood triglyceride and acute gouty arthritis attack rate related(p <0.05), but gender, age, past history of hypertension, diabetes, heart disease, kidney disease, cerebrovascular disease, upper gastrointestinal bleeding severity, blood uric acid, blood creatinine, blood urea nitrogen, blood total cholesterol level, blood transfusion and the use of proton pump inhibitor type and dosage is not relevant in the gout attack. Efficiency of small dose of colchicine combined with NSAIDs treatment was 100%, obviously superior to the single use of NSAIDs, which is 80%(P = 0.043), both groups had not induced or aggravated hemorrhage of digestive tract.Conclusions: Hypertriglyceridemia were significantly associated with acute gout attack in patients with upper gastrointestinal bleeding after use of proton pump inhibitors. Small doses of colchicine combined with NSAIDs treatment was safe, and exhibits a greater clinical curative effect for upper gastrointestinal bleeding combined with acute gout as compared to the single NSAIDs treatment, and the treatment of the digestive tract hemorrhage was not affected.