类风湿关节炎患者颈椎失稳的发生率及相关危险因素分析  

Prevalence and related factors of cervical spine instability in rheumatoid arthritis

作　　者：文振华 李敬扬 蒋会平 罗筱雯 田锋 张靓 何静芸 邓丽 周漫天 蒋中标[4] 

机构地区：[1]湖南省株洲市中心医院风湿免疫科,412007 [2]湖南省株洲市中心医院脊柱外科,412007 [3]湖南省株洲市中心医院放射科,412007 [4]中南大学湘雅二医院放射科

出　　处：《中华风湿病学杂志》2016年第5期299-303,共5页Chinese Journal of Rheumatology

基　　金：湖南省卫生厅科技项目（C2013-050）

摘　　要：目的探讨RA合并颈椎失稳的发生率及相关危险因素。方法对296例RA患者进行颈椎影像学检查及临床资料收集，通过t检验、X2检验及非对称多因素Logistic回归等统计方法进行分析。结果RA合并颈椎失稳的发生率为13．2％（39／296），颈椎失稳最常见的症状是颈痛[66．7％（26／39）]，12．8％（5／39）出现脊髓损伤。多因素回归分析显示其相关危险因素为外周关节骨破坏[OR：3．479，95％C1（1．330，8．079），P=0．012]、长时间使用激素[OR=2．532，95％CI（1．124，3．528），P=0．024]和病程[OR=1．562，95％C1（1．118，2．379），P=0．031]。结论颈椎失稳在RA患者中并不少见且可继发严重并发症，外周关节存在骨破坏、长时间使用激素和长病程的RA患者更容易出现颈椎失稳。Objective To survey the prevalence and identify risk factors of cervical spine instabilities in patients with rheumatoid arthritis （RA）. Methods Two hundred and ninety-six patients with RA were investigated, their demographic, clinical, and radiographic data were collected. A univariate and muhivariate unconditional-Logistic regression analysis was carried out to identify factors that best accounted for the occurrence of cervical spine instabilities in RA. Results The overall incidence rate was 13.2%（39/296）. The most common symptoms of cervical instabilities were neck pain [66.7%（26/39）], 12.8%（5/39） had spinal cord involvement. The regression analysis showed that the related factors were peripheral joint erosions [OR=3.479, 95%CI （1.330, 8.079）, P=0.012, long-term corticosteroids usage [OR=2.532, 95%CI （1.124, 3.528）, P=0.024] and long RA duration [OR=1.562, 95%CI（1.118, 2.379）, P=0.031]. Conclusion Cervical spine instability is not rare in patients with RA and maybe serious. Patients with peripheral joint erosions, long-term corticosteroids usage and long RA duration are prone to develop cervical spine instability.

关 键 词：关节炎 类风湿 颈椎 因素分析 统计学 横断面研究 

分 类 号：R593.22[医药卫生—内科学]