老年人类风湿性关节炎合并贫血的相关因素分析  

Analysis of factors related to rheumatoid arthritis in elderly patients with concurrent anemia

作　　者：孙泰[1] 万磊[2] 陆雅春[1] 宁芬[1] 李婷婷[1] 卢峰[1] 忻凌[3] 汪元[3] Sun Tai;Wan Lei;Lu Yachun;Ning Fen;Li Tingting;Lu Feng;Xin Ling;Wang Yuan(Department of Clinical Laboratory,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Department of Rheumatology,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China;Information Center,the First Affiliated Hospital of Anhui University of Chinese Medicine,Hefei 230031,China)

机构地区：[1]合肥安徽中医药大学第一附属医院检验中心,230031 [2]合肥安徽中医药大学第一附属医院风湿科,230031 [3]合肥安徽中医药大学第一附属医院信息中心,230031

出　　处：《中华老年医学杂志》2021年第9期1137-1141,共5页Chinese Journal of Geriatrics

基　　金：国家自然科学基金面上项目(81973655);新安医学教育部重点实验室开放基金项目(2020xayx01)。

摘　　要：目的分析老年人类风湿性关节炎(RA)合并贫血的相关因素。方法回顾性分析2019年5月至2020年5月在安徽中医药大学第一附属医院风湿科住院治疗的58例老年RA患者的临床资料,以血红蛋白(Hb)指标为基准,按照是否合并贫血将患者分为合并贫血组和非贫血组;比较两组患者的实验室检查结果和临床一般资料,通过二元Logistic回归分析RA合并贫血的相关因素,同时应用关联规则分析红细胞(RBC)与临床客观指标之间的强关联性。结果贫血和非贫血组患者一般临床资料的差异均无统计学意义(均P>0.05);而两组患者实验室指标超敏C反应蛋白(hs-CRP)、血小板/淋巴细胞计数(PLR)、低密度脂蛋白胆固醇(LDL-C)、总胆固醇(TC)、载脂蛋白B(ApoB)、白蛋白(Alb)、超氧化物歧化酶(SOD)、红细胞沉降率(ESR)、铁、平均红细胞血红蛋白量(MCH)和平均红细胞血红蛋白浓度(MCHC)的差异均有统计学意义(均P<0.05);二元Logistic回归分析结果显示,PLR(OR=3.718,95%CI:1.119~8.742,P=0.022)和LDL-C(OR=2.319,95%CI:1.026~3.061,P=0.038)是RA合并贫血的危险因素;关联规则分析结果显示,RBC的下降主要与PLR、hs-CRP、LDL-C指标的变化具有强关联性。结论老年人RA合并贫血与脂代谢和炎性指标水平密切相关,建议临床治疗时应密切关注脂代谢与炎症等指标水平的监测。Objective To analyze factors related to rheumatoid arthritis and anemia in elderly people.Methods Clinical data of 58 elderly patients with rheumatoid arthritis(RA)admitted to the Department of Rheumatology,the First Affiliated Hospital of Anhui Medical University from May 2019 to May 2020 were retrospectively analyzed.Patients were divided into the anemia group and the non-anemia group based on the hemoglobin(Hb)index.Laboratory test results and general clinical data were compared between the two groups.Factors related to RA with concurrent anemia were analyzed by binary Logistic regression analysis.Association rules analysis was conducted using SPSS Clementine to identify strong correlations between red blood cells(RBC)and objective clinical parameters.Results There was no significant difference in general clinical data between the two groups(all P>0.05).There were significant differences between the two groups in laboratory test results of high-sensitivity C-reactive protein(hs-CRP),platelet-to-lymphocyte ratio(PLR),low-density lipoprotein cholesterol(LDL-C),total cholesterol(TC),apolipoprotein B(ApoB),albumin(Alb),superoxide dismutases(SOD),erythrocyte sedimentation rate(ESR),Fe,mean corpuscular hemoglobin(MCH)and mean hemoglobin concentration(MCHC)(all P<0.05).Binary Logistic regression analysis showed that PLR(OR=3.718,95%CI:1.119-8.742,P=0.022)and LDL-C(OR=2.319,95%CI:1.026-3.061,P=0.038)were independent risk factors for RA with concurrent anemia.Association rules analysis showed that decline in RBC was strongly correlated with changes in PLR,hs-CRP and LDL-C.Conclusions RA with concurrent anemia in elderly patients is closely correlated with levels of molecules related to lipid metabolism and the inflammatory response.Close monitoring of lipid metabolism and inflammation is recommended during clinical treatment.

关 键 词：关节炎 类风湿 贫血 危险因素 

分 类 号：R593.22[医药卫生—内科学] R556[医药卫生—临床医学]