并发高尿酸血症银屑病关节炎患者的临床特征  

Clinical features of patients with psoriatic arthritis complicated by hyperuricemia

作　　者：屈嘉豪 赵娟[1] 宋志博[1] 张卓莉[1] QU Jia-hao;ZHAO Juan;SONG Zhi-bo;ZHANG Zhuo-li(Department of Rheumatology and Clinical Immunology,Peking University First Hospital,Beijing 100034,China)

机构地区：[1]北京大学第一医院风湿免疫科,北京100034

出　　处：《中华临床免疫和变态反应杂志》2022年第4期363-367,共5页Chinese Journal of Allergy & Clinical Immunology

摘　　要：目的对并发高尿酸血症(hyperuricemia,HUA)的银屑病关节炎(psoriatic arthritis,PsA)患者的临床特征进行研究,并探索相关因素。方法入组2009年1月至2022年1月在本院风湿免疫科就诊且临床资料完整的PsA患者,回顾性分析入组患者首次就诊时的临床及辅助检查资料,根据血尿酸水平分为HUA组和非HUA组,通过t检验、Mann-Whitney U检验、卡方检验或Fisher精确检验分别对两组患者的临床特征进行对比分析。结果362例PsA患者纳入本研究,中位年龄46.0(35.7,56.0)岁,208例(57.5%)男性,中位体质量指数(body mass index,BMI)24.0(22.3,26.7)kg m^(2)。166例(45.9%)有银屑病甲病,112例(30.9%)有指趾炎;对称性多关节型140例(38.7%),非对称性寡关节型139例(38.4%),中轴受累型44例(12.2%),残毁型33例(9.1%),远端指间关节型32例(8.8%)。362例患者中79例(21.8%)并发HUA,8例(2.2%)并发痛风。与不并发HUA患者相比,并发HUA的PsA患者BMI更高[26.1(24.0,28.6)vs.23.5(22.0,26.0)kg m^(2),P<0.001]、非对称性寡关节型更多见(51.9%vs.34.6%,P=0.005)、对称性多关节型更少见(29.1%vs.41.3%,P=0.048)、手指远端指间关节受累更少见(21.5%vs.33.9%,P=0.035)、并发高脂血症比例更高(50.6%vs.37.1%,P=0.030)。结论PsA并发HUA比较常见,超重是相关因素,PsA并发HUA患者的相关并发症管理需要关注。Objective To investigate the clinical characteristics of patients with psoriatic arthritis(PsA)complicated by hyperuricemia.Methods We enrolled PsA patients who visited our hospital and had complete clinical data from January 2009 to January 2022.Their clinical and laboratory data as well as comorbidities at first visit were retrospectively collected.The patients were divided into hyperuricemia group and non-hyperuricemia group.Analyses were performed by using independent samples t-test,Mann-Whitney U test,chi-square test or Fisher's exact test.Results 362 patients with PsA were included in this study,with a median age of 46.0(35.7,56.0),208(57.5%)males,and a median body mass index(BMI)24.0(22.3,26.7)kg m^(2).There were 166 patients(45.9%)with psoriatic nail disease,112 patients(30.9%)with dactylitis.Symmetrical polyarticular type was observed in 140(38.7%)patients,asymmetrical oligoarticular type in 139(38.4%)patients,axial involvement in 44(12.2%)patients,mutilating type in 33(9.1%)patients,and distal interphalangeal joint type in 32(8.8%)patients.Of 362 patients,79(21.8%)had hyperuricemia,and 8(2.2%)ever experienced attack of gouty arthritis.Compared with non-hyperuricemia group,PsA patients of hyperuricemia group had higher BMI[26.1(24.0,28.6)vs.23.5(22.0,26.0)kg m^(2),P<0.001],higher frequency of hyperlipidemia(50.6%vs.37.1%,p=0.030),more likely to have asymmetrical oligoarticular involvement(51.9%vs.34.6%,P=0.005),while less likely to have symmetrical polyarticular and distal interphalangeal joint involvement(29.1%vs.41.3%,P=0.048;21.5%vs.33.9%,P=0.035).Conclusions Hyperuricemia is common in PsA patients.Overweight is associated with hyperuricemia.The management of PsA patients complicated by hyperuricemia calls for more attention.

关 键 词：银屑病关节炎 并发症 高尿酸血症 

分 类 号：R589.7[医药卫生—内分泌] R758.63[医药卫生—内科学] R684.3[医药卫生—临床医学]