类风湿关节炎合并骨关节炎患者临床特点及相关因素分析  

Analysis of clinical characteristics and related factors in patients with rheumatoid arthritis and osteoarthritis

作　　者：魏竹节 王涛[1] 李志军[1] WEI Zhujie;WANG Tao;LI Zhijun(Department of Rheumatology and Immunization,the First Affiliated Hospital of Bengbu Medical College,Bengbu,Anhui,China,233004)

机构地区：[1]蚌埠医学院第一附属医院风湿免疫科,安徽蚌埠233004

出　　处：《分子诊断与治疗杂志》2022年第11期1942-1945,共4页Journal of Molecular Diagnostics and Therapy

基　　金：安徽省卫生健康软科学研究项目(2020WR03013)。

摘　　要：目的 探讨类风湿关节炎(RA)合并骨关节炎(OA)患者临床特点及相关因素,为临床诊治提供参考。方法 调查近年蚌埠医学院第一附属医院收治的符合RA诊断标准患者213例,将仅符合RA诊断标准的104例为对照组;既符合RA诊断标准又符合OA诊断标准的109例为观察组。收集入院时两组患者基本资料、临床表现与红细胞沉降率(ESR)、血清C反应蛋白(CRP)、类风湿因子(RF)、抗环瓜氨酸多肽(CCP)抗体等实验室及影像学检查结果。分析两组临床特点及与病情发生、发展相关的因素。结果 对照组年龄、BMI和病程低于观察组,差异有统计学意义(P<0.05);观察组晨僵数少于对照组,关节活动障碍、不对称关节症状例数及下肢大关节受累数多于对照组,肺高分辨CT示间质性肺病变表现少于对照组,CRP>10 mg/L、ESR>20 mm/h和RF、抗CCP抗体阳性率低于对照组,骨质疏松多于对照组,合并椎间盘突出症及糖尿病者以观察组为多,差异均有统计学意义(P<0.05)。多因素Logistic回归分析:患者年龄>60岁、BMI≥24 kg/m^(2)、病程>4年、饮酒≥2次/周、糖尿病及过敏史为RA合并OA发病的危险因素(P<0.05)。结论 RA合并OA好发于老年、病程较长者,晨僵时间短,不对称性关节症状及关节功能活动障碍多见;血清RF和抗CCP抗体阳性率较低;合并骨质疏松(OP)、椎间盘突出症及糖尿病较多。而高龄、高BMI、长病程、有饮酒习惯、糖尿病及过敏史等为RA合并OA的危险因素。Objective To explore the clinical characteristics and related factors of patients with rheumatoid arthritis(RA)combined with osteoarthritis(OA),and to provide a reference for clinical diagnosis and treatment. Methods A survey of 213 patients who met the diagnostic criteria for RA in our hospital in recent years was investigated,and 104 patients who only met the diagnostic criteria for RA were selected as the control group;109 patients who met both the diagnostic criteria for RA and OA were selected as the observation group. The basic data,clinical manifestations and erythrocyte sedimentation rate(ESR),serum C reactive protein(CRP),rheumatoid factor(RF),anti-cyclic citrullinated polypeptide(CCP)antibody and imaging results of the two groups of patients on admission were collected. The clinical characteristics and the factors related to the occurrence and development of the two groups were analyzed. Results The age,BMI index and disease duration in the control group were lower than those in the observed group,the difference was statistically significant(P<0.05). The number of morning stiffness in the observation group was less than that in the control group,the number of cases of joint movement disorders,asymmetric joint symptoms and the number of large joints of the lower extremities were more than those in the control group,and the high-resolution CT of the lung showed less interstitial lung lesions than the control group,and CRP > 10 mg/L,ESR > 20 mm/h and the positive rate of RF and anti-CCP antibody were lower than those in the control group,osteoporosis was more than that in the control group,and the patients with intervertebral disc herniation and diabetes were more in the observation group,and the differences were statistically significant(P<0.05). Multivariate Logistic regression analysis showed that age > 60 years old,BMI ≥ 24 kg/m^(2),disease duration > 4 years,drinking ≥ 2 times/week,diabetes and allergy history were risk factors for RA complicated with OA(P <0.05). Conclusion RA complicated with OA

关 键 词：类风湿关节炎 骨关节炎 临床特点 

分 类 号：R593.22[医药卫生—内科学] R684.3[医药卫生—临床医学]