类风湿关节炎初治患者颈椎失稳情况及临床特征  

Analysis of cervical instability and clinical characteristics in treatment-naive rheumatoid arthritis patients

作　　者：张璐[1] 胡小红[2] 陈澄[1] 蔡月明[1] 王庆文[1] 赵金霞[3] ZHANG Lu;HU Xiao-hong;CHEN Cheng;CAI Yue-ming;WANG Qing-wen;ZHAO Jin-xia(Department of Rheumatology&Immunology,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong,China;Department of medical imaging,Peking University Shenzhen Hospital,Shenzhen 518036,Guangdong,China;Department of Rheumatology&Immunology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学深圳医院风湿免疫科,广东深圳518036 [2]北京大学深圳医院影像科,广东深圳518036 [3]北京大学第三医院风湿免疫科,北京100191

出　　处：《北京大学学报（医学版）》2021年第6期1049-1054,共6页Journal of Peking University:Health Sciences

摘　　要：目的:研究初治类风湿关节炎(rheumatoid arthritis,RA)患者合并颈椎失稳者占比情况以及临床特征,并与经治RA患者颈椎失稳的发生情况及临床特点进行比较。方法:纳入2015年8月至2019年10月北京大学深圳医院和北京大学第三医院风湿免疫科住院期间行颈椎X线检查且有临床用药记录的RA患者,收集包括颈部症状等临床表现和实验室资料以及颈椎影像学资料进行分析。统计初治RA患者颈椎失稳人群的构成比,比较有无颈椎失稳两组初治RA患者的临床资料,比较初治及经治RA患者的颈椎失稳情况和临床特点。结果:408例RA患者中初治患者105例,女性87例,占82.9%,患者平均年龄(52±14)岁,病程中位数24个月,最短2周,最长30年。28.6%(30/105)合并颈椎失稳,其中病程≤24个月的初治RA颈椎失稳的发生率达13.6%。颈椎失稳组和无颈椎失稳组患者的颈部相关症状差异无统计学意义,与未合并颈椎失稳患者相比,颈椎失稳患者病程更长[60(18,180)个月vs.16(8,51)个月],更多合并外周关节畸形(63.3%vs.21.3%),血红蛋白水平较低[(106.90±21.61)g/L vs.(115.77±14.69)g/L],经治及初治RA患者颈椎失稳构成比差异无统计学意义。合并颈椎失稳RA患者中,初治RA患者除病程更短[120.0(72.0,240.0)个月vs.60.0(27.0,167.5)个月]外,各类型构成情况与经治RA患者差异无统计学意义。结论:初治RA患者颈椎失稳发生率较高,与经治RA患者颈椎失稳发生率相似,病程小于24个月的早期初治RA患者中已有相当比例合并颈椎失稳;颈部相关症状在初治RA患者合并颈椎失稳人群中并无明显特异性;对具有病程长、外周关节畸形比例高及血红蛋白水平低临床特点的初治RA患者应注意排查颈椎失稳。Objective:To study the proportion of cervical spine instability in treatment-naive rheumatoid arthritis(RA)patients,to investigate the associated neck symptoms,and to analyze the clinical characteristics in treatment-naive RA patients and treated RA patients.Methods:RA patients who underwent cervical spine X-ray imaging from the Department of Rheumatology and Immunology of Peking University Third Hospital and Peking University Shenzhen Hospital from August 2015 to October 2019 and had clinical records of medication administration were included.Clinical and laboratory data including cervical symptoms and X-ray imaging data of cervical spine were collected.The constituent ratio of cervical spine instability in treatment-naive RA patients was statistically analyzed.The clinical data and laboratory data were analyzed by t-test,u-test and chi square to explore the clinical characteristics of the treatment-naive RA patients with cervical instability.Results:Of the 408 RA patients,105 patients were treatment-naive.Of the 105 treatment-naive patients,82.9%(87/105)were female,with an average age of(52±14)years,the median duration of the disease was 24 months,the shortest history was 2 weeks,and the longest history was 30 years.28.6%(30/105)of the treatment-naive RA patients showed cervical spine instability.The prevalence of cervical instability was 13.6%in the treatment-naive RA patients with disease duration less than 24 months.Among them,there were no significant differences in neck symptoms between cervical spine instability group and none cervical spine instability group.The patients with cervical spine instability had a longer duration of disease[60(18,180)months vs.16(8,51)months],a higher proportion of peripheral joint deformity(63.3%vs.21.3%),and a lower hemoglobin[(106.90±21.61)g/L vs.(115.77±14.69)g/L].There was no significant difference in the occurrence of cervical instability in the treatment-naive RA patients compared with treated RA patients.Among the RA patients with cervical instability,there was no s

关 键 词：类风湿关节炎 颈椎失稳 外周关节畸形 颈部症状 

分 类 号：R593.22[医药卫生—内科学]