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目的了解国内医生诊治痛风的决策并对相关因素进行分析。方法对197名医生进行了关于痛风诊治决策的现场问卷调查,同时收集答卷人的个人资料,通过双变量分析和多重Logistic回归分析模型,分析影响决策的相关因素。结果一共收回120份有效答卷。在诊断痛风时,94名医生(78．3％)认为应该检查患者的关节滑液。在治疗急性痛风发作时,如果患者肾功能良好,83名医生(69．2％)首选口服秋水仙碱;如果患者肾功能不全,50名医生(41．7％)首选皮质激素或促皮质激素。在降血尿酸治疗时,99名医生(82．5％)选择的指征不当,107名医生(89．2％)治疗开始得太早,92名医生(76．7％)用药的时间不够长。另外,在开始降血尿酸治疗的同时,仅有17名医生(14．2％)预防急性痛风的发作。多重Logistic回归分析发现痛风继续教育是医生采取正确诊断方法的相关因素。结论国内医生诊治痛风的决策与目前国际较为公认的意见并不一致,高质量的医学继续教育有可能提高医生诊治痛风的决策水平。
Objective To understand the decision-making of gout for domestic doctors and analyze the related factors. Methods A total of 197 doctors conducted a field survey on the diagnosis and treatment of gout. At the same time, personal data of respondents were collected. Through the analysis of bivariate and multiple Logistic regression models, the related factors influencing decision-making were analyzed. A total of 120 valid responses were returned. In diagnosing gout, 94 physicians (78.3%) said they should check their synovial fluid. 83 patients (69.2%) preferred oral colchicine if their renal function was good in the treatment of acute gout attacks; 50 physicians (41.7%) preferred corticosteroids or corticosteroids in patients with renal insufficiency . At the time of hypoglycaemic treatment, 99 doctors (82.5%) chose improper indications, 107 doctors (89.2%) started treatment too early and 92 doctors (76.7%) did not take enough time long. In addition, only 17 physicians (14.2%) prevented the onset of acute gout at the same time as hypoururic acid therapy was started. Multiple Logistic regression analysis found that gout continued education is the doctor to take the correct diagnosis of related factors. Conclusions The decision-making of gout by domestic doctors is not consistent with the current more widely accepted international opinion. Continuing medical education with high quality may improve the doctor’s decision-making level of gout.