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podagra podagra zakruti tiski kak mojno tuje – poluchitsya revmatizm, a teper sdelayte eshe odin oborot – poluchitsya podagra. neizvestniy avtor v perevode s latinskogo podagra oznachaet «ogon v stope» podagra - zabolevanie, obuslovlennoe giperurikemiey i otlojeniem skopleniy kristallov urata natriya v tkanyax i proyavlyayusheesya porajeniem oporno-dvigatelnogo apparata i pochek. opredelenie podagri zabolevaemost uvelichivaetsya s vozrastom i povisheniem kontsentratsii mochevoy kisloti v krovi 5-28 sluchaev na 1000 mujchin i 1-6 sluchaev na 1000 jenshin podagra – samaya chastaya prichina razvitiya vospalitelnogo artrita u mujchin starshe 40 let. sootnoshenie mujchini : jenshini – 2-7 : 1 epidemiologiya podagri povishenie obrazovaniya mochevoy kisloti ili giperproduktsiya nedostatochnoe videlenie mochevoy kisloti ili gipoekskretsiya sochetanie oboix mexanizmov ili smeshanniy tip patogeneticheskie mexanizmi giperurikemii pervichnaya – vrojdennie defekti fermentativnoy sistemi. vtorichnaya –zloupotreblenie alkogolem (giperproduktsiya) ili zabolevaniya pochek, otravlenie svintsom, keto i laktatatsidoz, giperparatireoidizm, gipotireoidizm, priem lekarstvennix preparatov (aspirin, diuretiki). klassifikatsiya podagri: bessimptomnaya giperurikemiya ostriy podagricheskiy artrit …

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m proyavleniem podagri yavlyaetsya ostriy, nachinayushiysya vnezapno artrit, xarakterizuyushiysya bistro narastayushey silneyshey bolyu, giperemiey i gipertermiey, protekayushiy v bolshinstve sluchaev po tipu monoartrita. ostriy podagricheskiy artrit bolee chem v polovine sluchaev v debyute zabolevaniya porajaetsya perviy plyusnefalangoviy sustav, reje – sustavi plyusni, kolenniy i g/s sustavi. dlitelnost pristupov podagricheskogo artrita, kak pravilo, ne previshaet neskolkix dney, znachitelno sokrashayas pri prieme protivovospalitelnix sredstv. posle ataki artrita nastupaet bessimptomniy interval, nazivaemiy mejpristupnim periodom ostriy podagricheskiy artrit chastota i dlitelnost podagricheskix atak pri otsutstvii lecheniya postepenno uvelichivaetsya, mejpristupniy period sokrashaetsya, vovlekayutsya novie sustavi, effektivnost protivovospalitelnix preparatov snijaetsya, chto pri otsutstvii adekvatnoy terapii vlechet za soboy formirovanie tofusnoy formi zabolevaniya i xronicheskogo techeniya artrita. mejpristupniy period tofusi eto kristalli monourata, kotorie otkladivayutsya v vide depozitov razlichnix razmerov. nebolshie tofusi obnarujivayutsya vo mnogix organax i tkanyax uje v debyute zabolevaniya, a v sluchae xronicheskogo techeniya podagri postepenno formiruyutsya i krupnie podkojnie tofusi, obichno v oblasti …

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ofuse, sinovialnoy obolochke diagnostika polyarizatsionnaya mikroskopiya sinovialnaya jidkost soderjimoe tofusa identifikatsiya kristallov, nesmotrya na visokuyu chuvstvitelnost i spetsifichnost, trebuet ot issledovatelya bolshogo opita, i pri nevozmojnosti viyavleniya kristallov dlya diagnostiki podagri polzuyutsya klinicheskimi, rentgenologicheskimi i laboratornimi priznakami, vxodyashimi v nabor diagnosticheskix kriteriev podagri diagnostika ostrovoznikshiy assimetrichniy mono- oligoartrit sustava nijnix konechnostey (osobenno 1 plyusnefalangoviy sustav) nalichie tofusov giperurikemiya u mujchin bolee 0,42 mol/l, u jenshin bolee 0,36 mol/l kristalli monourata natriya v issleduemoy srede diagnosticheskie kriterii na rannix stadii zabolevaniya – otek myagkix tkaney vokrug porajennogo sustava pri xronicheskom techenii – erozii kostnoy tkani ili simptom «proboynika». raspolagayutsya v epifize kostey. imeyut skleroticheskuyu kaemku i navisayushie kraya, obrazuyushiesya pri razrushenii korkovogo veshestva. ne razvivaetsya osteoporoz net sujeniya sustavnoy sheli vplot do pozdney stadii. rentgenologicheskie priznaki rentgenologicheskie priznaki rentgenologicheskie priznaki rentgenologicheskie priznaki rentgenologicheskie priznaki fasetochniy sustav ostistiy otrostok artroskopicheskaya kartina artroskopicheskaya kartina taktika kupirovaniya ostrogo artrita 1. npvp – v standartnix …

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sii glyukokortikoidov prologirovannogo deystviya, v chastnosti diprospan ili kenalog. lechenie osnovnim metodom terapii xronicheskoy tofusnoy podagri i profilaktiki pristupov yavlyaetsya naznachenie urikostaticheskix lekarstvennix preparatov: ingibitor ksantinoksidazi – allopurinol v tabletkax po 100 mg v kombinatsii s nemedikamentoznimi metodami lecheniya (dietoterapiya, otkaz ot priema alkogolya, neobosnovannogo primeneniya diuretikov i nizkix doz salitsilatov). lechenie osnovnoy zadachey terapii yavlyaetsya dostijenie stoykoy normourikemii – tselevogo sivorotochnogo urovnya mochevoy kisloti nije 0,36 mol/l, minimiziruyushego veroyatnost razvitiya podagricheskogo artrita i predotvrashayushego formirovanie tofusov lechenie image3.jpeg image4.jpeg image5.jpeg image6.jpeg image7.jpeg image8.jpeg image9.jpeg image10.jpeg image11.jpeg image12.jpeg image13.jpeg image14.jpeg image15.jpeg image16.jpeg image17.jpeg image18.jpeg image19.jpeg image20.jpeg image21.jpeg image22.jpeg image23.jpeg image24.jpeg image25.jpeg image26.jpeg image27.png image28.png 99-14-0009 99-14-0020 01-14-0016 01-14-0013 99-14-0012 06-14-0070 07-14-0069 05-14-0058 99-14-0010 01-14-0019 gout: urate crystal 99-14-0025 01-14-0028 99-14-0043 99-14-0044 99-14-0045 gout: toe 03-14-0048 @©acr © 2008 americ: 05-14-0056 05-14-0061 05-14-0060 /docprops/thumbnail.jpeg

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podagra podagra zakruti tiski kak mojno tuje – poluchitsya revmatizm, a teper sdelayte eshe odin oborot – poluchitsya podagra. neizvestniy avtor v perevode s latinskogo podagra oznachaet «ogon v stope» podagra - zabolevanie, obuslovlennoe giperurikemiey i otlojeniem skopleniy kristallov urata natriya v tkanyax i proyavlyayusheesya porajeniem oporno-dvigatelnogo apparata i pochek. opredelenie podagri zabolevaemost uvelichivaetsya s vozrastom i povisheniem kontsentratsii mochevoy kisloti v krovi 5-28 sluchaev na 1000 mujchin i 1-6 sluchaev na 1000 jenshin podagra – samaya chastaya prichina razvitiya vospalitelnogo artrita u mujchin starshe 40 let. sootnoshenie mujchini : jenshini – 2-7 : 1 epidemiologiya podagri povishenie obrazovaniya mochevoy kisloti ili giperproduktsiya nedostatochnoe vid...

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