{"id":497,"date":"2009-08-26T12:05:54","date_gmt":"2009-08-26T13:05:54","guid":{"rendered":"https:\/\/turanuslu.net\/?p=497"},"modified":"2022-01-14T09:10:22","modified_gmt":"2022-01-14T09:10:22","slug":"gut-hastaligi","status":"publish","type":"post","link":"https:\/\/turanuslu.net\/ar\/gut-hastaligi\/","title":{"rendered":"\u0645\u0631\u0636 \u0627\u0644\u0646\u0642\u0631\u0633"},"content":{"rendered":"

\u0645\u0631\u0636 \u0627\u0644\u0646\u0642\u0631\u0633<\/h2>\n

\"\"<\/p>\n


\nGut hastal\u0131\u011f\u0131, daha \u00e7ok 30- 45 ya\u015f aras\u0131 erkeklerde ve 55-70 ya\u015flar\u0131ndaki kad\u0131nlarda g\u00f6r\u00fclen bir romatizmal hastal\u0131kt\u0131r.<\/p>\n

V\u00fccutta p\u00fcrin ad\u0131 verilen ve h\u00fccre DNA\u2019s\u0131nda kullan\u0131lan bir n\u00fckleik asit vard\u0131r. P\u00fcrin n\u00fckleik asitlerinin y\u0131k\u0131lmas\u0131 sonucu kanda \u00fcrik asit olu\u015fur. Normal sa\u011fl\u0131kl\u0131 insanlarda ne kadar \u00fcrik asit olu\u015fursa o kadar \u00fcrik asit idrar yoluyla at\u0131l\u0131r. B\u00f6breklerdeki bir bozukluktan yada fazla miktarda \u00fcrik asit \u00fcretilmesinden dolay\u0131 kanda \u00fcrik asit seviyesi artarsa gut hastal\u0131\u011f\u0131 ortaya \u00e7\u0131kar.<\/div>\n

E\u011fer bir nedenle, \u00fcrik asit at\u0131lamay\u0131p kanda belirli bir d\u00fczeyin \u00fcst\u00fcnde birikirse, \u00e7\u00f6z\u00fcnm\u00fc\u015f durumdan kat\u0131 hale ge\u00e7ebilir, di\u011fer bir de\u011fi\u015fle kristalle\u015febilir. Kristal halinde olan bu molek\u00fcl bir s\u00fcre sonura eklem, deri alt\u0131, b\u00f6brek gibi dokularda birikip bu dokular\u0131n yap\u0131s\u0131nda de\u011fi\u015fikliklere sebep olarak fonksiyonlar\u0131n\u0131 bozabilir.<\/p>\n

Kandaki a\u015f\u0131r\u0131 \u00fcrik asit doygunlu\u011fu sonucu, doku aral\u0131klar\u0131ndan ge\u00e7erek eklem i\u00e7i ve \u00e7evresi yap\u0131larda biriken \u00fcrik asit burada h\u0131zla geli\u015fen iltihaba sebep olarak eklemde s\u0131v\u0131 art\u0131\u015f\u0131na, k\u0131zar\u0131kl\u0131\u011fa, hareket k\u0131s\u0131tl\u0131l\u0131\u011f\u0131na ve a\u011fr\u0131lara yol a\u00e7ar. En tipik olarak ayak ba\u015f parma\u011f\u0131, ayak bile\u011fi ve diz eklemleri tutulur. Eklem a\u011fr\u0131s\u0131 genellikle a\u011f\u0131r bir yemekten sonra ortaya \u00e7\u0131kar ve \u00e7ok \u015fiddetlidir. \u00d6yle ki hasta etkilenmi\u015f b\u00f6lgeyi yorgana bile de\u011fdiremez. Akut gut bir g\u00fcn i\u00e7inde d\u00fczelir. Ancak, tedavi edilmezse a\u011fr\u0131l\u0131 n\u00f6betlerin aras\u0131 gittik\u00e7e azal\u0131r, ve hasta daha s\u0131k olarak gut n\u00f6beti ge\u00e7irmeye ba\u015flar.<\/div>\n

\"\"<\/p>\n

B\u00f6breklerde ise, \u00f6zellikle \u00fcrik asit d\u00fczeyinin \u00e7ok y\u00fcksek oldu\u011fu (erkeklerde:13 mg\/dl, kad\u0131nlarda: 10mg\/dl) durumlarda, s\u00fczme kanallar\u0131 i\u00e7inde ta\u015f olu\u015fumu g\u00f6r\u00fclebilir.<\/div>\n
Genel olarak, b\u00f6brekteki ta\u015f olu\u015fumlar\u0131n\u0131n % 5-10 kadar\u0131ndan \u00fcrik asit \u00e7\u00f6kelmesi sorumludur. S\u0131cak ve kuru iklimlerde ya\u015fayanlarda b\u00f6brekten at\u0131lan su miktar\u0131 ve idrar\u0131n asit oran\u0131 y\u00fcksek oldu\u011fundan \u00fcrik aside ba\u011fl\u0131 b\u00f6brek ta\u015f\u0131 daha s\u0131k ortaya \u00e7\u0131kmaktad\u0131r. Her \u00fcrik asidi y\u00fcksek olanda gut hastal\u0131\u011f\u0131 ortaya \u00e7\u0131kmaz. Yap\u0131lan ara\u015ft\u0131rmalara g\u00f6re, y\u00fcksek \u00fcrik asidi olanlar\u0131n \u00fc\u00e7te birinde belirtiler ortaya \u00e7\u0131k\u0131ar. Klinik bir belirti olmadan, yaln\u0131zca \u00fcrik asit seviyesinin y\u00fcksek olmas\u0131na hiper\u00fcrisemi; e\u011fer, bu y\u00fckseklik sonucu yukar\u0131da tan\u0131mlanan belirtiler ortaya \u00e7\u0131km\u0131\u015f ise di\u011fer bir de\u011fi\u015fle hastal\u0131k olu\u015fmu\u015fsa, bu duruma gut deniliyor.<\/div>\n
\u00dcrik asit, iki ana sebeple kanda y\u00fcksek olabilir; ya v\u00fccutta fazla \u00fcretilir ya da b\u00f6brek \u00fcretileni d\u0131\u015far\u0131ya atmay\u0131p kanda biriktirir. \u00dcrik asidin kandaki normal en y\u00fcksek d\u00fczeyi 7,0 mg\/dl dolay\u0131ndad\u0131r. Gut hastal\u0131\u011f\u0131nda ise en yayg\u0131n olarak g\u00f6r\u00fclen d\u00fczey 7,0 – 9,0mg\/dl aras\u0131ndad\u0131r.<\/div>\n
Hastalar\u0131n % 80 – 90\u2019\u0131nda d\u0131\u015far\u0131dan yiyecekler yolu ile p\u00fcrinin a\u015f\u0131r\u0131 al\u0131n\u0131p olu\u015fan \u00fcrik asidin b\u00f6breklerin yeterince s\u00fczememesi sonucunda kanda birikmesi ana sebeptir. %10 – 20\u2019 sinde de v\u00fccudun bir \u00e7ok de\u011fi\u015fik sebeple, \u00fcrik asidi kendi kendine fazla oranda olu\u015fturmas\u0131 s\u00f6z konusudur.<\/div>\n
Baz\u0131 ila\u00e7lar (aspirin, di\u00fcretikler) toksik maddeler (alkol ve kur\u015fun zehirlenmesi) tiroid bezinin az \u00e7al\u0131\u015fmas\u0131 (hipotiroid), gebelik toksemisi, hipertansiyon, a\u015f\u0131r\u0131 kilo (obezite), kronik b\u00f6brek yetmezli\u011fi, a\u00e7l\u0131k, \u00fcrik asidin at\u0131lmas\u0131n\u0131 engelleyerek kan seviyesinin y\u00fckselmesine sebep olan fakt\u00f6rlerdir.<\/div>\n
B\u00f6bre\u011fin i\u015fleyi\u015fi tamamen normal olsa da, \u00fcrik asidin v\u00fccutta a\u015f\u0131r\u0131 \u00fcretimi sonucu hiper\u00fcrisemi geli\u015fip bir s\u00fcre sonra guta d\u00f6n\u00fc\u015febilir. \u00c7ok ender olarak do\u011fu\u015ftan gelen enzim eksikli\u011fine ba\u011fl\u0131 sebepler s\u00f6z konusu oldu\u011funda daha k\u00fc\u00e7\u00fck ya\u015flarda hastal\u0131k ortaya \u00e7\u0131kabilir. Kemik ili\u011finde yada lenf bezlerinden geli\u015fen kanserlerde, baz\u0131 kan hastal\u0131klar\u0131nda, vitamin B_12 eksikli\u011finde, sedef hastal\u0131\u011f\u0131nda b\u00f6bre\u011fin durumundan ba\u011f\u0131ms\u0131z olarak \u00fcrik asit fazlal\u0131\u011f\u0131 ortaya \u00e7\u0131kabilir ve gut hastal\u0131\u011f\u0131na yol a\u00e7abilir.<\/div>\n
Genel olarak guta sebep olan etkenin \u00fcrik asit d\u00fczeyinin y\u00fcksek olmas\u0131 g\u00f6sterilir. Ancak \u00e7ok nadir de olsa \u00fcrik asit seviyesi normal oldu\u011fu halde gut ortaya \u00e7\u0131kabilir. Gut n\u00f6beti tedavi edilemez ise, bir y\u0131l i\u00e7erisinde %60 ihtimalle yeniden ortaya \u00e7\u0131kar. Tedavi edilmedik\u00e7e ataklar aras\u0131 s\u00fcre k\u0131sal\u0131r ve zamanla, y\u0131llar i\u00e7inde deri alt\u0131nda tof\u00fcs ad\u0131 verilen birikintiler olu\u015fur. Tof\u00fcsler; kulak kep\u00e7esinde ve ekstremitelerin ekstans\u00f6r y\u00fczeylerinde g\u00f6r\u00fcl\u00fcr. Tedavi edilmeyen gut b\u00f6breklerde ta\u015f olu\u015fturur ve kronik b\u00f6brek yetmezli\u011fine d\u00f6n\u00fc\u015febilir.<\/div>\n

Gut\u2019un tedavisi:<\/strong><\/p>\n

Tedavide \u00f6ncelikle kanda \u00fcrik asit seviyesinin y\u00fckselmesine sebep olan fakt\u00f6rlerin tespit edilmesi ve bunlar\u0131n tedavisi gerekir. Hastan\u0131n zay\u0131flat\u0131lmas\u0131, \u00fcrik asit y\u00fcksekli\u011fine sebep olan ila\u00e7lar\u0131n (aspirin, di\u00fcretik) dozunun ayarlanmas\u0131, hiperglisemi (\u015feker hastal\u0131\u011f\u0131) varsa tedavisi genel sa\u011fl\u0131k a\u00e7\u0131s\u0131ndan da gereklidir.<\/div>\n
Akut gut ata\u011f\u0131n\u0131n tedavisinde kol\u015fisin ve indometazin \u00f6nemli ila\u00e7lard\u0131r. Kol\u015fisin dozu g\u00fcnde 7 mg ge\u00e7memelidir. \u0130lk 24 saatten sonra doz 2-3 tablete d\u00fc\u015f\u00fcr\u00fcl\u00fcr. A\u011fr\u0131l\u0131 d\u00f6nem ge\u00e7tikten sonra 6-12 ay kadar g\u00fcnde1 tablet kol\u015fisin kullan\u0131l\u0131r.<\/div>\n
Ayr\u0131ca sakatat, k\u0131rm\u0131z\u0131 et, sardunya, hindi, hamsi, somon bal\u0131\u011f\u0131, \u0131spanak, f\u0131nd\u0131k, f\u0131st\u0131k k\u0131s\u0131tlanmas\u0131 gereken g\u0131da maddeleridir. Alkol kullan\u0131m\u0131 yasaklanmal\u0131d\u0131r.<\/div>","protected":false},"excerpt":{"rendered":"

\u0645\u0631\u0636 \u0627\u0644\u0646\u0642\u0631\u0633<\/p>","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[400],"tags":[489,490,491,401],"class_list":["post-497","post","type-post","status-publish","format-standard","hentry","category-romatizmal-hastaliklar","tag-gut","tag-gut-hastaligi","tag-gut-hastaligi-tedavisi","tag-romatizmal-hastaliklar"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/turanuslu.net\/ar\/wp-json\/wp\/v2\/posts\/497","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/turanuslu.net\/ar\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/turanuslu.net\/ar\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/turanuslu.net\/ar\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/turanuslu.net\/ar\/wp-json\/wp\/v2\/comments?post=497"}],"version-history":[{"count":1,"href":"https:\/\/turanuslu.net\/ar\/wp-json\/wp\/v2\/posts\/497\/revisions"}],"predecessor-version":[{"id":10749,"href":"https:\/\/turanuslu.net\/ar\/wp-json\/wp\/v2\/posts\/497\/revisions\/10749"}],"wp:attachment":[{"href":"https:\/\/turanuslu.net\/ar\/wp-json\/wp\/v2\/media?parent=497"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/turanuslu.net\/ar\/wp-json\/wp\/v2\/categories?post=497"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/turanuslu.net\/ar\/wp-json\/wp\/v2\/tags?post=497"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}