Abstract
Objective To explore the clinical features and associated factors in rheumatoid arthritis(RA) patients with comorbidities,so as to provide a reference for comprehensively assessing the prognosis and delivering medical services for these patients.Methods The enrolled participants were 223 cases with RA diagnosed and treated in Department of Rheumatism and Immunology of the First Affiliated Hospital of Wenzhou Medical University between January and December 2013.We reviewed their clinical data,recorded their baseline characteristics(results of laboratory and imaging examinations),status of comorbidities,and analyzed the associated factors of RA and the correlations between them.Results Comorbidities were found in 84.8%(189/233) of the participants,which mainly included 16 different diseases,such as hyperlipidemia (41.3%,92/233),hypertension (40.8%,91/233),osteoporosis or osteopenia(24.7%,55/233),diabetes (17.5%,39/233),hyperuricemia (13.9%,31/233),urinary calculi (13.5%,30/233) and so on.Hyperlipidemia in RA had straight line correlation with Disease Activity Score 28(DAS28) (rs=-0.146,P<0.05),ESR (rs=-0.153,P<0.05),blood pressure (rs=0.194,P<0.05),serum uric acid (rs=0.216,P<0.05);hypertension in RA had straight line correlation with age (rs=0.353,P<0.05),TJC (rs=0.161,P<0.05),SJC (rs=0.148,P<0.05),fasting blood glucose (rs=0.290,P<0.05),blood lipid (rs=0.194,P<0.05),serum uric acid (rs=0.220,P<0.05),abnormal bone mineral density (rs=0.202,P<0.05);osteoporosis or osteopenia in RA had linear correlation with male (rs=-0.173,P<0.05),age (rs=0.362,P<0.05),blood pressure (rs=0.202,P<0.05);diabetes in RA had straight line correlation with age (rs=0.245,P<0.05),TJC (rs=0.145,P<0.05),DAS28 (rs=0.182,P<0.05),CRP (rs=0.195,P<0.05),blood pressure (rs=0.290,P<0.05);hyperuricemia in RA had straight line correlation with male(rs=0.141,P<0.05),age (rs=0.172,P<0.05),blood pressure (rs=0.220,P<0.05),blood lipid (rs=0.216,P<0.05);urinary calculi in RA had straight line correlation with CRP (rs=0.135,P<0.05).Multivariate Logistic regression analysis showed that blood pressure and serum uric acid were the risk factors of RA combined with hyperlipidemia (P<0.05);age,fasting blood glucose,blood lipid and serum uric acid were the risk factors of RA with hypertension(P<0.05);female and age were the risk factors of RA with osteoporosis or osteopenia (P<0.05);course of RA,CRP and blood pressure were the risk factors of diabetes in RA (P<0.05);male,blood pressure and blood lipid were the risk factors of RA and hyperuricemia coexistence(P<0.05).Conclusion Due to gender,age,abnormal blood pressure and blood lipid,patients with RA are prone to such comorbidities as hyperlipidemia,hypertension,osteoporosis,diabetes,hyperuricemia and so on,which would worsen the outcome and decrease the quality of life.Therefore,in order to better improve the prognosis of RA and reduce the associated consequences of comorbidities,a ample understanding,screening and effective management are needed in comorbidities in RA besides the clinical active treatment of RA.关键词
关节炎/类风湿/共病现象/影响因素分析Key words
Arthritis/rheumatoid/Comorbidity/Root cause analysis分类
医药卫生
