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例1.男,51岁,务农。尿频、尿急、血尿反复发作三年。尿常规:蛋白+,白细胞■,红细胞■,脓球■,草酸钙结晶■。腹部平片未见阳性结石,泌尿科以尿路感染请我科会诊。检查:体温正常,心肺(-),面部无浮肿。两手第一、二掌指关节及两足第一跖趾关节畸形,上有二、三个结节样隆起,溃破结痂,无触痛。耳廓触及结节,下肢无浮肿,血压110/80mmHg。追问病史:关节肿痛伴发热反复发作约35年,以两手指及足趾关节为主,膝关节为次,多次求医均诊断为风湿性关节炎,服用激素有效。近三年关节畸形,且有尿频、尿急、腰痛、血尿,当地医院诊断为尿路感染,多次住院中西医结合治疗无效。查血尿酸21mg％,血沉60mm,血抗“O”,正常,尿尿酸1.4g/24小时。服别嘌呤醇四周,症状改善,尿常规接近正常。例2.男,50岁。关节肿痛伴发热呈间歇性发作十年,四、五个医院均诊断为风湿性关节炎,激
Example 1. Male, 51 years old, farming. Frequent urination, urgency, hematuria recurrent three years. Urine: protein +, white blood cells ■, red blood cells ■, pus ball ■, calcium oxalate crystals ■. No positive flat abdominal film, urology urinary tract infection, please contact our department consultation. Check: normal body temperature, heart and lung (-), no swelling of the face. Two hands first, two hands and two feet metatarsophalangeal metatarsophalangeal joint deformity, there are two or three nodules uplift, crushing scab, no tenderness. Auricle touch nodules, lower extremity no edema, blood pressure 110 / 80mmHg. Asked history: joint swelling and pain with recurrent fever about 35 years, with two fingers and toe joints, knees for the times, multiple medical diagnosis were diagnosed with rheumatoid arthritis, taking hormone effective. Nearly three years of joint deformity, and frequent urination, urgency, back pain, hematuria, the local hospital diagnosis of urinary tract infection, multiple hospital Integrative Medicine invalid. Check serum uric acid 21mg%, erythrocyte sedimentation rate 60mm, blood resistance “O”, normal, uric acid 1.4g / 24 hours. Allopurinol for four weeks, the symptoms improved, near normal urine. Example 2. Male, 50 years old. Joint swelling and pain with intermittent onset of fever was ten years, four or five hospitals were diagnosed with rheumatoid arthritis, irritation