全国多中心类风湿关节炎患者发生骨折的调查研究
전국다중심류풍습관절염환자발생골절적조사연구
A multicenter study of fracture in patients with rheumatoid arthritis in China
  • 万方数据
    中华风湿病学杂志 중화풍습병학잡지
    CHINESE JOURNAL OF RHEUMATOLOGY
    2012年 2期 102-106 ,共5页

    王莉枝%王彩虹%李小峰%赵向聪%赵文鹏%王秀茹%苏茵%安媛%周云杉%朱平%陈丽娜%王国春%卢昕%靳洪涛%王永福%杨荣%张卓莉%李光韬%刘湘源%孙琳%张风肖%陶杰梅%李振彬%杨静%林金盈%韦美秋%崔刘福%舒荣%刘晓敏%柯丹%胡绍先%叶丛%杨岫岩%李昊%黄慈波%高明%赖蓓%李兴福%宋立军%栗占国

    왕리지%왕채홍%리소봉%조향총%조문붕%왕수여%소인%안원%주운삼%주평%진려나%왕국춘%로흔%근홍도%왕영복%양영%장탁리%리광도%류상원%손림%장풍초%도걸매%리진빈%양정%림금영%위미추%최류복%서영%류효민%가단%호소선%협총%양수암%리호%황자파%고명%뢰배%리흥복%송립군%률점국

    关节炎,类风湿%骨折%危险因素 關節炎,類風濕%骨摺%危險因素
    관절염,류풍습%골절%위험인소
    目的 研究我国类风湿关节炎(RA)患者发生骨折的临床特征,进一步评估发生骨折的危险因素.方法 设计专门的登记表,随机现场调查全国9省市18个医院门诊及住院RA患者681例,收集的资料包括年龄、性别、病程、关节受累表现、治疗情况、骨折的发生情况等.采用Logistic回归分析对RA患者发生骨折的相关危险因素进行评估.结果 在此次调查的681例RA患者中有48例共发生过54处骨折,骨折发生率达8％.骨折发生在不同部位,足/踝、股骨、脊柱及腕为多发部位.Logistic回归分析骨折危险因素显示:病程长(OR:1.245,95％CI:0.987～1.570,P=0.065)、男性(OR:0.433,95％CI:0.199～0.942,P=0.035)、畸形关节数多(OR:1.042,95％ CI:1.006～1.079,P=0.023)、有RA家族史(OR:2.201,95％CI:0.984～4.923,P=0.055)、健康测量量表(SF-36)分数高(OR l.017,95％CI:1.002～1.033,P=0.028)增加了RA患者发生骨折的风险.骨折的危险因素按强弱顺序依次为:病程、SF-36、性别、畸形关节数、RA家族史.结论 RA患者中骨折的发生率高,病程长、男性、畸形关节数多、RA家族史阳性为RA患者发生骨折的危险因素.早期对RA患者评估危险因素,积极治疗阻断疾病发展、避免关节发生畸形,对防治RA患者的骨质疏松、减少骨折的发生有利.
    목적 연구아국류풍습관절염(RA)환자발생골절적림상특정,진일보평고발생골절적위험인소.방법 설계전문적등기표,수궤현장조사전국9성시18개의원문진급주원RA환자681례,수집적자료포괄년령、성별、병정、관절수루표현、치료정황、골절적발생정황등.채용Logistic회귀분석대RA환자발생골절적상관위험인소진행평고.결과 재차차조사적681례RA환자중유48례공발생과54처골절,골절발생솔체8％.골절발생재불동부위,족/과、고골、척주급완위다발부위.Logistic회귀분석골절위험인소현시:병정장(OR:1.245,95％CI:0.987～1.570,P=0.065)、남성(OR:0.433,95％CI:0.199～0.942,P=0.035)、기형관절수다(OR:1.042,95％ CI:1.006～1.079,P=0.023)、유RA가족사(OR:2.201,95％CI:0.984～4.923,P=0.055)、건강측량량표(SF-36)분수고(OR l.017,95％CI:1.002～1.033,P=0.028)증가료RA환자발생골절적풍험.골절적위험인소안강약순서의차위:병정、SF-36、성별、기형관절수、RA가족사.결론 RA환자중골절적발생솔고,병정장、남성、기형관절수다、RA가족사양성위RA환자발생골절적위험인소.조기대RA환자평고위험인소,적겁치료조단질병발전、피면관절발생기형,대방치RA환자적골질소송、감소골절적발생유리.
    Objective To examine the clinical features of fractures and related risk factors in patients with rheumatoid arthritis (RA) in China.Methods Six hundred and eighty-one RA patients were randomly selected from department of rheumatology of 18 hospitals of China.Data were obtained from the questionnaire,including age,sex,disease duration,the involvement of joints,treatment regimen,features of fractures etc.The possible risk factors of fracture in patients with RA were analyzed with a multi-variate Logistic regression analysis.Results ① In 681 RA patients of the survey,48 patients had 54 fractures,and the incidence of fractures was about 8％.② Fractures occurred at various sites.Foot/ankle,femur,spine and wrist were the most frequent sites.③ The Logistic regression analysis showed that several factors increased the risk of fracture in RA patients,including long disease duration (OR:1.245,95％CI:0.987-1.570,P=0.065),male gender (OR:0.433,95％CI:0.199-0.942,P=0.035),more deformed joints (OR:1.042,95％CI:1.006-1.079,P=0.023),family history of RA (OR:2.201,95％CI:0.984-4.923,P=0.055),and high scores of SF-36 (OR:1.017,95％CI:1.002-1.033,P=0.028).④ According to the degree of correlation from strong to weak,the risk factors of fracture were disease duration,SF-36,sex,number of deformed joints and family history of rheumatoid arthritis.Conclusion The incidence of fracture is high in patients with rheumatoid arthritis.Several factors could increase the risk of fractures in RA patients,including long disease duration,male gender,more deformed joints,and family history of RA.In order to prevent the occurrence of fractures,cautions should be taken to prevent the development of fractures and treat the disease aggressively to suppress the disease activity of RA.
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