148例活动性类风湿性关节炎临床特征分析  

Clinical characteristics of 148 cases of active rheumatoid arthritis

作　　者：王玉姣 孙绍峰[2] 王雪梅[3] 杨志伟 沙尚清 陈娟[2] 池淑红[3] WANG Yujiao;SUN Shaofeng;WANG Xuemei;YANG Zhiwei;SHA Shangqing;CHEN Juan;CHI Shuhong(Department of Respiratory Medicine,Yinchuan Third People′s Hospital,Yinchuan,Ningxia 750004,China;Department of Respiratory and Critical Care Medicine,General Hospital of Ningxia Medical University,Yinchuan,Ningxia 750004,China;Department of Rheumatology and Immunology,General Hospital of Ningxia Medical University,Yinchuan,Ningxia 750004,China;Department of Rheumatology,Wuzhong People′s Hospital Affiliated to Ningxia Medical University,Yinchuan,Ningxia 751100,China)

机构地区：[1]宁夏回族自治区银川市第三人民医院呼吸内科,750004 [2]宁夏医科大学总医院呼吸与危重症医学科,银川750004 [3]宁夏医科大学总医院风湿免疫科,银川750004 [4]宁夏医科大学附属吴忠市人民医院血液风湿科,751100

出　　处：《重庆医学》2019年第18期3104-3106,3110,共4页Chongqing medicine

基　　金：宁夏回族自治区自然科学基金项目(NZ17161);宁夏医科大学校级课题(XZ2017009)

摘　　要：目的探讨活动性类风湿性关节炎(RA)的临床特点,为临床诊疗提供基线资料。方法收集2015年9月至2018年1月宁夏医科大学总医院风湿免疫科就诊的148例RA患者病历资料,根据疾病活动度(DAS28)评分,分为疾病活动组(65例)和高度活动组(83例),比较两组之间临床特征。结果148例RA患者中,男女比例1.0∶2.7,<45岁者占20.3%,45~<60岁者占40.5%,≥60岁者占39.2%。148例RA患者的首发关节部位为累及外周小关节者占69%,也可以累及特殊关节为首发表现。RA肺累及的发生率为41.2%(61/148)。RA出现贫血的比例为47.3%(70/148),其中中度贫血占12.9%,轻度贫血占87.1%。疾病活动组和高度活动组CRP、ESR、RF滴度、CCP阳性率、AKA阳性率、IgG、IgM、C3、D-二聚体差异均有统计学意义(P<0.05)。结论活动性RA可以累及特殊关节起病,出现贫血、肺累及等,RF滴度、CCP阳性率、AKA阳性率等可作为疾病活动严重度的判定指标。Objective To explore the clinical characteristics of active rheumatoid arthritis (RA) and provide baseline data for the disease understanding. Methods Clinical data from 148 cases of RA patients admitted to our hospital from September 2015 to January 2018 was collected.According to DAS28 score,they were divided into the disease activity group (65 cases) and the hyperactivity group (83 cases).And the differences in clinical characteristics between the two groups were compared. Results Among 148 RA patients,the ratio of male to female was 1.0∶2.7,20.3% were <45 years old,40.5% were between 45-<60 years old,and 39.2% were ≥60 years old.The rate of peripheral facet joint involvement as the first joint site in 148 RA patients was 69%,and the involvement of special joints can also be a onset.The rate of RA-ILD was 41.2%(61/148).The rate of anemia in RA patients was 47.3%(70/148),12.9% for moderate anemia and 87.1% for mild anemia.There were statistically significant differences in CRP,ESR,RF titer,CCP positive rate,AKA positive rate,IgG,IgM,C3 and D-dimer between the disease activity group and the hyperactivity group (P < 0.05 ). Conclusion Active RA may involve specific joint as the onset which result in anemia,lung involvement,etc.RF titer,CCP-positive rate and AKA positive rate can be used as indexes for severity evaluation of the disease activity.

关 键 词：关节炎 类风湿 肺疾病 间质性 DAS28评分 

分 类 号：R593[医药卫生—内科学]