是的。利尿剂可增加患上一种称为痛风的关节炎的风险。痛风是由于血液中一种称为尿酸的物质在关节中积聚并形成结晶所致。
利尿剂会导致排尿增多，因此可能增加患痛风的风险。排尿增多会减少体内的液体量。但剩余的液体会更浓缩。这可造成更容易形成导致痛风的结晶。某些类型的利尿剂还会影响肾脏排出部分尿酸（称为尿酸盐）的能力。尿酸盐排泄减少会增加痛风的风险。
如果您在服用利尿剂治疗高血压时患上痛风，请与医疗护理专业人员讨论您的药物。询问您应该继续服用利尿剂还是换用另一种药物。许多其他类型的降压药不会增加痛风的风险。此外，许多有助于降低血压的健康习惯也有助于降低尿酸。请参考以下建议：
- 健康饮食。多吃水果和蔬菜、植物蛋白、低脂或脱脂乳品和全谷物食品。如果您每天摄入大约 2000 卡路里，请将肉类和海鲜的量限制在每天 170 克（6 盎司）或更少。
- 少喝酒或不喝酒。
- 限制含糖饮料，如汽水。还要限制含有高果糖玉米糖浆这种甜味剂的食物和饮料。
- 通过饮食和运动减掉多余的体重。您可以让医疗护理专业人员为您推荐适合您的目标体重。
为了帮助控制痛风，请多喝水。还要限制含有大量嘌呤的食物和饮料。身体分解嘌呤时会形成尿酸盐。高嘌呤食物和饮料包括：
- 猪肉、家禽和牛肉等肉类。
- 香肠和熟食肉等加工肉类。
- 内脏，如肝脏。
- 沙丁鱼、鲭鱼、鲱鱼、扇贝和贻贝等海鲜。
- 酒精。
显示参考文献
- Firestein GS, et al. Etiology and pathogenesis of hyperuricemia and gout. In: Firestein & Kelley's Textbook of Rheumatology. 11th ed. Elsevier; 2021. https://www.clinicalkey.com. Accessed May 22, 2024.
- Stamp LK. Diuretic-induced hyperuricemia and gout. https://www.uptodate.com/contents/search. Accessed May 22, 2024.
- Gout. National Institute of Arthritis and Musculoskeletal and Skin Diseases. https://www.niams.nih.gov/health-topics/gout. Accessed May 22, 2024.
- High blood pressure: Treatment. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/health/high-blood-pressure/treatment. Accessed May 22, 2024.
- AskMayoExpert. Gout or pseudogout (adult). Mayo Clinic; 2023.
- Which foods are safe for gout? Arthritis Foundation. https://www.arthritis.org/health-wellness/healthy-living/nutrition/healthy-eating/which-foods-are-safe-for-gout. Accessed May 22, 2024.
- Wu B, et al. Availability and quality of published data on the purine content of foods, alcoholic beverages, and dietary supplements. Journal of Food Composition and Analysis. 2019; doi:10.1016/j.jfca.2019.103281.
- Zeratsky KA (expert opinion). Mayo Clinic. May 29, 2024.
- Lowering your blood pressure with DASH. National Heart, Lung, and Blood Institute. https://www.nhlbi.nih.gov/. Accessed May 29, 2024.
Original article: https://www.mayoclinic.org/zh-hans/diseases-conditions/gout/expert-answers/diuretics-and-gout/faq-20058146