不同年龄类风湿关节炎患者临床特征分析  

Clinical Features of Rheumatoid Arthritis Patients with Different Age

作　　者：闫慧明[1] 王永福[1] 

机构地区：[1]包头医学院第一附属医院风湿免疫科,内蒙古包头市014010

出　　处：《中国全科医学》2012年第20期2259-2261,共3页Chinese General Practice

摘　　要：目的探讨不同年龄类风湿关节炎(RA)患者的临床特征。方法收集2006年12月—2011年12月我院风湿免疫科确诊的RA患者194例,按发病年龄分为幼年组(<16岁)、中青年组(16～60岁)、老年组(>60岁)。了解不同年龄RA患者的一般情况、实验室检查结果及脏器受累情况。结果 (1)幼年组RA患者免疫球蛋白M(IgM)、类风湿因子-IgA(RF-IgA)、类风湿因子-IgG(RF-IgG)、类风湿因子-IgM(RF-IgM)水平较中青年组及老年组显著升高(P<0.05),而白细胞计数(WBC)、抗环瓜氨酸抗体(抗CCP)、尿素氮、肌酐水平均较中青年组及老年组显著降低,差异均有统计学意义(P<0.05);老年组患者血清C反应蛋白(CRP)、尿素氮、肌酐水平较中青年组显著升高,而抗CCP滴度则较中青年组显著降低,差异有统计学意义(P<0.05)。(2)幼年组患者发热、血管炎、血液系统受累者显著多于中青年组及老年组,差异有统计学意义(P<0.05);老年组患者肺间质病变、胃肠受累者显著多于幼年组及中青年组,差异有统计学意义(P<0.05);中青年组以关节变形、类风湿结节、心脏受累多见,但与幼年组及老年组比较,差异无统计学意义(P>0.05)。结论血清RF-IgG、RF-IgA、RF-IgM、IgM水平在幼年组显著升高,血清抗CCP滴度在中青年组显著升高,血清CRP、肌酐、尿素氮水平在老年组显著升高,幼年组WBC显著低于老年组及中青年组;幼年RA患者以发热、血管炎、血液系统受累多见,老年RA患者则以肺间质病变、胃肠受累多见。Objective To evaluate the clinical features of rheumatoid arthritis（RA） of patients with different age.Methods 194 patients confirmed with RA in the department of rheumatology of our hospital from December 2006 to December 2011 were collected and divided into juvenile group（〈16 years）,middle-aged group（16 to 60 years） and aged group（〉60 years）.The general conditions,laboratory examination results and organ involvement of the patients were analyzed.Results（1） The levels of IgM,RF-IgA,RF-IgG and RF-IgM in juvenile group were significantly higher than those of middle-aged group and aged group（P〈0.05）,while the levels of white blood cell count（WBC）,anti CCP,urea nitrogen and creatinine in juvenile group were significantly lower than those of middle-aged group and aged group（P〈0.05）.The levels of serum CRP,urea nitrogen and creatinine in aged group were significantly higher than those of middle-aged group,while the level of anti CCP was significantly lower than middle-aged group（P〈0.05）.（2） The cases with fever,vasculitis and hematologic involvement in juvenile group were significantly more than those of middle-aged group and aged group（P〈0.05）.The cases with pulmonary interstitial lesions and gastrointestinal involvement in aged group were significantly more than those of juvenile group and middle-aged group（P〈0.05）.Joint deformation,rheumatoid nodules and cardiac involvement were seen in middle-aged group,but showed no statistically differences compared with juvenile group and aged group（P〉0.05）.Conclusion Serum RF-IgG,RF-IgA,RF-IgM and IgM are significantly increased in juvenile group.Anti CCP is significantly increased in middle-aged group.Serum CRP,creatinine and blood urea nitrogen are significantly increased in aged group.WBC of juvenile group is significantly lower than that of aged group and middle-aged group.Fever,vasculitis and hematologic involvement are commonly seen among juvenile patients with RA,while pulmonary interstitial lesions and

关 键 词：关节炎  类风湿 老年人 关节炎  幼年型类风湿 

分 类 号：R593.2[医药卫生—内科学]