类风湿关节炎患者223例共病现象的临床特征及其相关因素分析

发布时间：2018-03-05 22:35

本文选题：关节炎　切入点：类风湿　出处：《中国全科医学》2017年18期 　论文类型：期刊论文

【摘要】：目的探讨类风湿关节炎(RA)患者共病现象的临床特点及其相关影响因素,为全面评估患者预后及干预疾病提供临床依据。方法回顾性选取2013年1—12月在浙江省温州医科大学附属第一医院风湿免疫科诊治的符合纳入标准的223例RA患者的临床资料。记录患者一般资料和辅助检查结果,统计患者的共病情况,并分析RA共病现象与各指标的相关性及其影响因素。结果 223例RA患者中84.8%(189/223)存在共病现象,共发现16种,主要为高脂血症(41.3%,92/223)、高血压(40.8%,91/223)、骨质疏松症或骨量减少(以下简称骨松)(24.7%,55/223)、糖尿病(17.5%,39/223)、高尿酸血症(13.9%,31/223)、肾结石(13.5%,30/223)等。RA合并高脂血症与疾病活动指数(DAS28)评分(r_s=-0.146)、红细胞沉降率(ESR)(r_s=-0.153)、血压(r_s=0.194)、血尿酸(r_s=0.216)存在直线相关关系(P0.05);RA合并高血压与年龄(r_s=0.353)、压痛关节数(TJC)(r_s=0.161)、肿胀关节数(SJC)(r_s=0.148)、血糖(r_s=0.290)、血脂(r_s=0.194)、血尿酸(r_s=0.220)、骨密度异常(r_s=0.202)存在直线相关关系(P0.05);RA合并骨松与男性(r_s=-0.173)、年龄(r_s=0.362)、血压(r_s=0.202)存在直线相关关系(P0.05);RA合并糖尿病与年龄(r_s=0.245)、TJC(r_s=0.145)、DAS28评分(r_s=0.182)、C反应蛋白(CRP)(r_s=0.195)、血压(r_s=0.290)存在直线相关关系(P0.05);RA合并高尿酸血症与男性(r_s=0.141)、年龄(r_s=0.172)、血压(r_s=0.220)、血脂(r_s=0.216)存在直线相关关系(P0.05);RA合并肾结石与CRP存在直线相关关系(r_s=0.135,P0.05)。Logistic回归分析示,血压、血尿酸是RA合并高脂血症的危险因素(P0.05);年龄、血糖、血脂、血尿酸是RA合并高血压的危险因素(P0.05);女性、年龄为RA合并骨松的危险因素(P0.05);RA病程、CRP、血压为RA合并糖尿病的危险因素(P0.05);男性、血压、血脂为RA合并高尿酸血症的危险因素(P0.05)。结论 RA患者易发生共病现象,以高脂血症、高血压、骨松、糖尿病、高尿酸血症等为主,导致上述共病现象的主要影响因素有性别、年龄、血压、血脂等;而这些共病现象影响RA患者的预后和生活质量,因此,临床上除积极治疗原发病外,同时需要充分认识RA患者共病现象并对其进行筛查和有效管理,才能更好地改善RA预后及减轻共病所致的相关后果。
[Abstract]:Objective to investigate the clinical characteristics and related factors of co-disease in patients with rheumatoid arthritis (RA). Methods the clinical data of 223 RA patients who were diagnosed and treated in the Department of Rheumatology Immunology affiliated to Wenzhou Medical University in Zhejiang Province from January to December in 2013 were selected retrospectively. Bed data. Records of patients' general information and results of auxiliary examinations, The incidence of co-disease in patients with RA was analyzed, and the correlation and influencing factors were analyzed. Results among 223 patients with RA, 84.8 / 223 (18.9 / 223) were found to be co-diseased, and 16 of them were found. The main ones are hyperlipidemia 41.32 / 222, hypertension 40.8g / 91 / 223, osteoporosis or reduction of bone mass (hereinafter referred to as Osteoporosis 24.775% 55 / 2223, diabetes 17.555 / 39 / 2223, hyperuricemia 13.931 / 3223, renal calculi 13.550 / 30223) .RA with hyperlipidemia and disease activity index (DAS28) scores RSS-0.146, erythrocyte sedimentation rate and erythrocyte sedimentation rate. There is a linear correlation between the number of hypertensives and age, the number of tenderness joints, the number of swollen joints, the number of swollen joints, the number of swollen joints, the number of SJCCrs0.148, the blood glucose of 0.290, the blood fat of 0.194, the serum uric acid of 0.220, the abnormal bone density of 0.220, the abnormal bone density of 0.202). There is a linear correlation between RA with diabetes mellitus and age with diabetes mellitus and DAS28 with DAS28 score rs0. 182C-reactive protein CRPrs0. 290). There is a linear correlation between Rs0. 05 and Rs0. 290). There is a linear correlation between Rs0. 05 and Rs0. 141 in men, 0. 172 in age, 0. 220 in blood pressure, 0. 220 in blood lipids.) there is a linear correlation between 0. 05 and 0. 141, 0. 172, 0. 220, 0. 220, 0. 216.) there is a linear correlation between Rs0. 05 and Rs0. 141, age and age, 0. 172, 0.220, 0.220, and 0. 216). There was a linear correlation between RA and CRP. Logistic regression analysis showed that there was no significant difference between RA and CRP. Blood pressure and uric acid were the risk factors of RA with hyperlipidemia, age, blood glucose, blood lipid and serum uric acid were risk factors of RA with hypertension. Age is the risk factor of RA combined with osteosarcoma (P 0.05), the course of RA is CRP, the blood pressure is the risk factor of RA with diabetes mellitus (P 0.05), the male, blood pressure and blood lipid are the risk factors of RA with hyperuricemia (P 0.05). Conclusion the patients with RA are prone to co-disease, and hyperlipidemia is the risk factor. Hypertension, osteosarcoma, diabetes, hyperuricemia and so on, the main factors that cause these syndromes are sex, age, blood pressure, blood lipids, etc., and these co-diseases affect the prognosis and quality of life of patients with RA. In addition to active treatment of the primary disease, it is necessary to fully understand, screen and manage the co-disease phenomenon in RA patients, so as to improve the prognosis of RA and alleviate the related consequences.
【作者单位】：浙江省乐清市人民医院内科;浙江省玉环县人民医院影像科;温州医科大学;温州医科大学附属第一医院风湿免疫科;
【分类号】：R593.22

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