Saturday, September 11, 2004

醫師觀點》痛風 運動員的無奈宿命

痛風是國人常見的慢性病之一,台北市立和平醫院痛風科主任陳峙仰表示,運動員每天從事跑、跳等激烈運動,其實是種無氧運動,它會讓體內出現無氧代謝狀態,產生過多的乳酸,抑制腎臟正常排出尿酸的功能。一旦尿酸累積過多,濃度偏高,長期下來就會導致痛風。

一般人的尿酸在7.0mg/dl(每百毫升尿液7.0毫克尿酸)以下,若超過這個標準值,即屬偏高。陳峙仰指出,尿酸指數超過標準值,並不意味痛風會立即發作,但尿酸指數愈高,痛風發作的機率也愈高。

醫界研究顯示,尿酸指數超過9.0的患者,3、5年內引發第一次痛風的機率,高達九成以上,不難想見其殺傷力。雖然養成低普林飲食習慣可減少尿酸在體內的累積,但成效並不顯著。陳峙仰說,不少研究發現,飲食習慣對東方人罹患痛風的影響不大,只佔體質的六分之一,通常他只建議民眾不要暴飲暴食,至於飲食內容,也只提醒他們少吃肉類、海鮮、動物內臟等高普林食物而己;相較下,他會強烈建議尿酸偏高的人,最好少碰啤酒等酒類,以免痛風一發不可收拾。

陳峙仰舉日本相撲選手為例,這些為了增加自已「份量」,據以在土俵上有效衝撞對手的「重量級人士」,在大吃大喝之餘,往往還會喝上幾杯啤酒,致使尿酸指數普遍偏高,痛風也隨之而來,健康當然亮起紅燈。

然而,讓陳峙仰尤其擔心的是,部分運動員出現痛風後,為了止痛,常自行到坊間藥房亂配止痛藥來吃,由於這些止痛藥常摻有類固醇,且劑量通常很高,短時間內還不會吃出問題,一旦長期服用,類固醇會抑制腎上腺功能,進而形成依賴性。一旦停藥,腎上腺素停止分泌,人就會覺得四肢無力且疲倦不堪,出現「腎上腺素低下症」。

所幸,即使到了這個地步,仍有緩解餘地。陳峙仰表示,此時只要逐漸減少類固醇的服用量,再努力控制尿酸指數,體內腎上腺素就會慢慢恢復正常,不再全身一副軟趴趴的模樣。 【2004/08/31 民生報】

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