不同性别类风湿关节炎患者的伴随疾病和用药现状研究  

Concomitant Disease and Drug of Choice in Patients with Rheumatoid Arthritis in Different Genders

作　　者：徐丽玲[1] 朱华群[1] 钟华 苏茵[1] XU Li-ling;ZHU Hua-qun;ZHONG Hua;SU Yin(Department of Rheumatology&Immunology,Peking University People's Hospital,Beijing 100044,China)

机构地区：[1]北京大学人民医院风湿免疫科,北京市100044

出　　处：《中国全科医学》2018年第25期3101-3106,共6页Chinese General Practice

基　　金：国家自然科学基金资助项目(81671609)

摘　　要：目的了解不同性别类风湿关节炎(RA)患者的伴随疾病及临床药物选择情况。方法选取2014年9月—2015年9月就诊于北京大学人民医院的15 353例RA患者为研究对象。利用医渡云软件提取RA患者的就医信息,包括性别、年龄、病情相关血清学指标、伴随疾病及药物选择情况。采用χ~2检验对不同性别患者的伴随疾病及药物选择情况进行统计学分析。结果患者中男4 002例(26.07%),女11 351例(73.93%),男女比例约为1∶2.8。RA患者常伴随的风湿性疾病包括干燥综合征(SS)(5.24%)、系统性红斑狼疮(SLE)(2.53%)及强直性脊柱炎(AS)(1.07%);除≥65岁SLE外,女性患者合并SS和SLE的比例高于男性(P<0.05),男性患者合并AS的比例高于女性(P<0.05)。其他前10种伴随疾病依次为骨关节炎(37.56%)、骨质疏松(33.37%)、高血压(29.87%)、高脂血症(19.49%)、冠心病(19.16%)、消化性溃疡(16.80%)、脑血管病(13.59%)、慢性胃炎(13.11%)、糖尿病(10.90%)及动脉粥样硬化(10.17%);除慢性胃炎、≤44岁脑血管病及≥65岁骨关节炎、高脂血症、脑血管病、动脉粥样硬化外,不同年龄段男女RA患者上述其他慢性病患病率均有差异(P<0.05)。RA患者选择的前10种治疗药物依次为:来氟米特(54.63%)、甲氨蝶呤(26.20%)、羟氯喹(23.14%)、双氯芬酸钠(22.20%)、洛索洛芬(21.20%)、塞来昔布(20.20%)、白芍总苷(18.52%)、糖皮质激素(16.77%)、美洛昔康(15.90%)及柳氮磺吡啶(13.75%);男性RA患者选择来氟米特的比例高于女性(P<0.05),而女性选择甲氨蝶呤、羟氯喹、糖皮质激素及白芍总苷的比例高于男性(P<0.05)。结论男性与女性RA患者的伴随疾病和用药选择明显不同,临床工作中应予以重视。Objective To explore concomitant disease and drug use in patients with rheumatoid arthritis(RA)in clinical practice between different genders,thus raising the awareness of patients with RA.Methods A total of 15 353 patients admitted to Peking University People's Hospital were enrolled from September 2014 to September 2015.Their basic information,including gender,age,laboratory features and drug use were collected from clinical laboratory information system and electronic medical record system of Yidu Cloud Technology Company Ltd.Statistical analysis of concomitant disease and drug use were compared by chi-square test.Results Among the subjects,4 002 were male(26.07%)and 11 351 female(73.93%),with a ratio of approximately 1∶2.8.The common concomitant rheumatic diseases in patients with RA were sjogren syndrome(SS,5.24%),systemic lupus erythematosus(SLE,2.53%),and ankylosing spondylitis(AS,1.07%).Except for RA patients aged 65 years and over,the prevalence rates of SS and SLE in female patients with RA were higher than those in male(P<0.05),and of AS in male patients with RA was higher than that in female(P<0.05).Other concomitant diseases were osteoarthritis(37.56%),osteoporosis(33.37%),hypertension(29.87%),hyperlipidaemia(19.49%),coronary heart disease(19.16%),peptic ulcer(16.80%),cerebrovascular disease(13.59%),chronic gastritis(13.11%),diabetes(10.90%),and atherosclerosis(10.17%).The significant difference was found on above-mentioned concomitant diseases(except chronic gastritis,cerebral vascular disease in patients aged 44 years or below and osteoarthritis,hyperlipidemia,cerebrovascular disease and atherosclerosis in patients aged 65 years and over)between female and male patients with RA in different ages(P<0.05).The most common 10 kinds of drugs used in patients with RA were leflunomide(54.63%),methotrexate(26.20%),hydroxychloroquine sulfate(23.14%),diclofenac(22.20%),loxoprofen(21.20%),celecoxib(20.20%),total glucosides of paeony(18.52%),glucocorticoid(16.77%),meloxicam(15.90%)and sulfasalazine(13.75%).T

关 键 词：关节炎 类风湿 性别分布 伴随疾病 药物选择 

分 类 号：R593.22[医药卫生—内科学]