青年与老年类风湿关节炎合并冠心病患者的临床特点比较  

Comparative analysis of the clinical features of rheumatoid arthritis complicated with coronary atherosclerotic heart disease between young and elderly patients

作　　者：王洁[1] 房丽华[1] 张成强[1] 刘晓萍[1] 崔潞萍[1] 聂婷婷[1] 李瑞[1] Wang Jie;Fang Lihua;Zhang Chengqiang;Liu Xiaoping;Cui Luping;Nie Tingting;Li Rui(Department of Rheumatology and Immunology,Shanxi Provincial People’s Hospital,Taiyuan 030012,China)

机构地区：[1]山西省人民医院风湿免疫科,太原030012

出　　处：《中国医药》2020年第10期1505-1508,共4页China Medicine

基　　金：山西省青年科技研究基金(201901D211517)。

摘　　要：目的比较青年类风湿关节炎(YORA)与老年类风湿关节炎(EORA)合并冠心病(冠状动脉粥样硬化性心脏病,CHD)患者的临床特点。方法回顾性收集2016年1月至2018年12月在山西省人民医院诊断类风湿关节炎(RA)合并CHD患者129例的病历资料,按资料完整程度进行年龄分层抽样,年龄<60岁,即YORA-CHD组60例;年龄≥60岁,即EORA-CHD组69例。比较2组患者一般资料、实验室指标和临床症状。结果 RA-CHD患者发病年龄集中于50-79岁。EORA-CHD组急性冠状动脉综合征发生率明显高于YORA-CHD组[94.2%(65/69)比78.3%(47/60)](P=0.009)。YORA-CHD组男性、吸烟比例明显高于EORA-CHD组,发病年龄、高血压病程、糖尿病比例、吸烟指数、空腹血糖、关节肿胀数及DAS28-红细胞沉降率评分均明显低于EORA-CHD组(均P <0.05)。结论 EORA-CHD组较YORA-CHD组急性冠状动脉综合征发生率高,与EORA-CHD多为女性、长期高血压、患有糖尿病、吸烟指数高或关节症状不易控制等因素有关。Objective To compare the clinical features between young onset rheumatoid arthritis(YORA) with coronary atherosclerotic heart disease(CHD)and elderly onset rheumatoid arthritis(EORA)with CHD.Methods A total of 129 RA patients complicated with CHD diagnosed in Shanxi Provincial People’s Hospital from January 2016 to December 2018 were selected.According to patients’age<60 years or≥60 years,they were divided into the YORA-CHD group(60 cases)and the EORA-CHD group(69 cases).The general data,clinical features and laboratory indexes were compared between the two groups.Results The onset age of RA-CHD was concentrated at 50-79 years old.The incidence of acute coronary syndrome in EORA-CHD group was significantly higher than that in YORA-CHD group[94.2%(65/69)vs 78.3%(47/60)](P=0.009).The proportion of male and smoking in YORA-CHD group were significantly higher than those in EORA-CHD group,and the onset age,duration of hypertension,proportion of diabetes,smoking index,fasting blood glucose,joint swelling number and DAS28-erythrocyte sedimentation rate score in YORA-CHD group were significantly lower than those in EORA-CHD group(all P<0.05).Conclusion The EORA-CHD group had a higher incidence of acute coronary syndrome than the YORA-CHD group,which was related to the fact that EORA-CHD patients were mostly female,long-term hypertension,diabetes,higher smoking index or uncontrollable joint symptoms.

关 键 词：类风湿关节炎 冠心病(冠状动脉粥样硬化性心脏病) 青年 老年 临床特点 

分 类 号：R593.22[医药卫生—内科学]