Correlations among hyperuricemia, hypercholesterolemia, coronary disease and hypertension.
Correlations among hyperuricemia, hypercholesterolemia, coronary disease and hypertension.
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高尿酸血症、高胆固醇血症、冠心病和高血压之间的相关性。
DOI：
10.1002/art.1780080449
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发表时间：
1965
影响因子：
--
通讯作者：
Arthur P. Hall
中科院分区：
文献类型：
--
作者：
Arthur P. Hall
在试图评估高尿酸血症、痛风性关节炎和其他疾病状态之间可能存在的联系时，有几种方法是开放的。人们可以调查痛风性关节炎或其他疾病状态的问题时，无论是严重到足以把受试者的专家或医院。在痛风性关节炎的情况下，这意味着当它严重到足以产生多次疼痛发作，肾结石，肾衰竭或其他并发症。考虑到肾结石，高血压，胆囊炎等都是说服受试者他应该来医院的相当有说服力的论据，所涉及的病例选择是显而易见的。绝大多数关于痛风性关节炎和其他疾病之间相关性的报道都是基于这种方法，并且是旧文献中报道的许多相关性的原因。这些报告进一步复杂化的声明完全基于临床印象，对或错。总的来说，这些报告中没有提供对照组，或者用作对照组的组来自保险表或政府死亡率表，这些表基于完全不可比较的受试者选择和检查方法。这些报告多年来被引用和重新引用，难以逃脱。例如，一个被广泛引用的参考文献被引用来支持高血压和动脉粥样硬化在痛风性关节炎患者中更常见的论点，反过来，显然是基于五个以前的参考文献。其中一项研究是关于囚犯和狱警的血压，另一项是关于评估动脉粥样硬化患病率的统计方法的研究，没有提到痛风或高尿酸血症。其中一个描述了三个有痛风性关节炎长期病史的病人，其中两个超过70岁，因心肌梗死入院。第四篇报告了一个医院系列中的55例痛风性关节炎，其中17例有肾脏疾病，许多人有尿毒症和高血压。第五个参考文献是临床印象的陈述。此外，大多数较早的文献很难解释，因为这些研究早于我们对禁食、酸中毒或小剂量水杨酸盐对尿酸值影响的认识，并且没有尝试将患有肾脏疾病、白血病等的受试者分开。这些报告大部分发表于20世纪30年代或更早。因此，我将请求您的宽容，避免进一步描述这种类型的报告。这并不是说报道大量痛风患者的情况没有价值，无论他们是否
In attempting to evaluate the association which may exist between hyperuricemia, gouty arthritis, and other disease states, several avenues of approach are open. One may investigate gouty arthritis or other disease states in question when either is severe enough to bring the subject to the specialist or to the hospital. In the case of gouty arthritis this means when it is severe enough to have produced multiple painful attacks, renal stones, renal failure or other complications.Considering the fact that renal stones, hypertension, cholecystitis, etc. are all fairly persuasive arguments in convincing the subject that he ought to come to the hospital, the case selection involved is apparent. The vast majority of reports on the association between gouty arthritis and other diseases are based on this approach and are responsible for the many associations reported in the older literature. These reports are further complicated by statements based solely on clinical impression, right or wrong. By and large, no control groups are offered in thess reports or the groups used as controls are drawn from insurance tables or government tables of mortality which are based on entirely uncomparable methods of subject selection and examination. These reports have been quoted and requoted over the years and have been difficult to escape. For example, one widely quoted reference which is cited to support the contention that hypertension and atherosclerosis are more common in patients with gouty arthritis is, in turn, apparently based on five previous references. Of these one, a study of blood pressure in prisoners and prison guards, and another which is a study of statistical methods of evaluating the prevalence of atherosclerosis, do not mention gout or hyperuricemia. One describes three patients with long histories of gouty arthritis, two of whom were over 70, admitted to a hospital with myocardial infarction. The fourth reports 55 cases of gouty arthritis in a hospital series, 17 of whom had kidney disease and many of whom were uremic and hypertensive. The fifth reference is a statement of clinical impression. In addition, most of the older literature is very difficult to interpret since the studies antedate our knowledge of the ef-fects of fasting, acidosis or small doses of salicylates on uric acid values, and make no attempt to separate the subjects with renal disease, leukemia and so forth. Most of these reports were published in the 1930’s or before. I will beg your indulgence, therefore, in refraining from further description of reports of this variety. That is not to say that there is nolt value in reporting what happens in a large number of gouty subjects, whether they