关键词: 痛风, 达标治疗, 影响因素分析, 尿酸

Abstract: Background　Gout is a common crystal-induced arthritis.Although treat-to-target therapies for gout have been reported in many recent studies，the effectiveness of such therapies in China is not satisfactory.Objective　To explore the prevalence and associated factors of achieving target uric acid（UA）level in gout patients.Methods　113 patients with a clinical diagnosis of gout were randomly sampled from Northern Jiangsu People's Hospital，Affiliated Hospital to Yangzhou University from September 2016 to January 2019，and all patients received 6 months of gout treatment up to standard.The clinical data were collected by questionnaire，and the patients were examined in laboratory and imaging.According to the UA standard of patients after treatment，the patients were divided into compliance group and non compliance group.Multiple Logistic regression analysis was used to explore the influencing factors of UA standard of gout patients.Results　Out of 113 patients，105 completed the survey.The rate of achieving target UA was 65.7%（69/105）.Both the UA level and urate crystal deposition decreased after treatment（P<0.05）.Those who achieved target UA level had higher rates of normal BMI，no tophus and no hyperlipidemia，disease duration greater than 5 years，increased / similar drinking volume，no less than 2 000 ml of drinking water，exercising less than 5 times a week，and normal liver function compared with those who did not（P<0.05）.Multivariate Logistic regression analysis showed that abnormal liver functions（OR=9.641），increased / similar drinking volume（OR=13.970），no less than 2 000 ml of drinking water（OR=0.189）and exercise frequency greater than 5 times a week is not less than five times a week（OR=3.421）were associated with the rate of achieving target UA level（P<0.05），while different uric acid-lowering drug therapies were not associated with it（χ2=1.357，P=0.716）.Conclusion　The treat-to-target therapy can significantly reduce the content of urate crystal in the gouty joints and surrounding tissues.Abnormal liver function，increased / similar drinking volume，and exercising 5 or more times a week are independent factors associated with decreased effectiveness of treat-to-target therapy while no less than 2 000 ml of drinking water is associated with increased effectiveness of treat-to-target therapy.

Key words: Gout, Treat to target, Root cause analysis, Uric acid