【摘要】 目的 通过分析脊柱痛风患者的资料特点，提高临床医生对该病诊断的准确率。方法 收集我院收治的3例脊柱痛风患者的临床资料，并结合相关文献进行复习。结果 3例患者既往均确诊有痛风，均因出现颈部或腰部神经受累症状接受手术治疗。患者1血尿酸（sUA）水平正常，患者2、3的sUA水平升高。患者1、3术前脊柱磁共振检查可见T₂WI信号减低，其中患者1的C3～7锥体炎性变可能性大；患者3的C4～6锥体可见环状高密度影，及清晰硬化边缘。患者1、2术后病理检查可见痛风性肉芽肿，患者3见少许纤维血管组织呈慢性炎症伴玻璃样变、肉芽增生及多核巨细胞反应。术后3例患者神经压迫症状均不同程度缓解。结论 痛风患者出现神经压迫症状，影像学检查有痛风典型骨损害特点，应考虑脊柱痛风诊断的可能，需要及时完善sUA及尿酸盐结晶沉积的检查，术前明确脊柱痛风诊断，充分做好术前准备。更多还原

【Abstract】 Objective To investigate the features of patients with spinal gout, and to improve diagnostic accuracy among clinicians. Methods Related clinical data were collected from three patients with spinal gout who were admitted to our hospital, and a literature review was performed. Results All three patients had previously been diagnosed with gout and received surgical treatment for the symptoms of cervical or lumbar nerve involvement. Patient 1 had a normal level of serum uric acid（sUA）, while patients 2 and 3 had an increase in the level of sUA. For patients 1 and 3, preoperative spinal magnetic resonance showed decreased T₂WI signal, and patient 1 had a high possibility of inflammation of the cervical vertebrae C3-7, while patient 3 had circular high-density shadow and clear sclerotic edge in the cervical vertebrae C4-6. Postoperative pathological examination showed gouty granuloma in patients 1 and 2, and patient 3 was found to have chronic inflammation with hyaline change, granulomatous hyperplasia, and multinucleated giant cell reaction in fibrovascular tissue. All three patients achieved varying degrees of relief of nerve compression symptoms after surgery. Conclusion The possibility of spinal gout should be considered if patients with gout have nerve compression symptoms and the features of typical bone damage in gout found by radiological examination, and it is necessary to complete the examination of sUA and urate crystal deposition in time, confirm the diagnosis of spinal gout before surgery, and make adequate preparation before surgery.更多还原