161例住院类风湿关节炎患者临床分析

Clinical analysis of 161 inpatients with rheumatoid arthritis

目的：研究住院类风湿关节炎（RA）患者的临床特征及各特征间的相关性。方法：收集2008年3月~2010年3月符合1987年美国风湿协会RA诊断标准的161例住院RA患者的临床资料。用SPSS15软件统计患者的发病年龄、病程、关节肿痛数、血小板数（Plt）,血沉（ESR）、C-反应蛋白（CRP）、类风湿因子（RF）、抗环胍氨酸肽（CCP）抗体的数据,并分析其相关性。将患者依据是否血清抗CCP抗体≥3倍正常值分为2组,比较不同滴度抗CCP抗体的RA患者的特点。结果：住院RA患者的关节压痛数与关节肿痛数、Plt、RF均显著正相关（r=0.642、0.16、0.203,均P〈0.05）;病程数与关节畸形、CRP均正相关（r=0.465、0202,均P〈0.05）;ESR与Plt、CRP、RF均正相关（r=0.187、0.291、0.171,均P〈0.05）;CRP与Plt、RF均正相关（r=0.498、0.156,均P〈0.05）。与抗CCP抗体〈3倍RA患者相比,抗CCP抗体≥3倍以上的RA患者的病程更长（P〈0.05）、RF更高（P〈0.01）、畸形更多见（P〈0.05）。结论：住院RA患者的临床表现（关节肿痛数）与其血清学炎症检查指标（Plt、ESR、CRP）及RF、抗CCP抗体间存在正相关关系;具有高滴度抗CCP抗体（血清抗CCP抗体≥正常值3倍）的RA患者病程更长、RF更高、关节畸形更多见,应针对性积极治疗,以减少关节畸形的发生,提高RA患者的生存质量。

Objective：To investigate the clinic data of 161 patients hospitalized with rheumatoid arthritis（RA）and research the correlation of integral of joints respectively with serological infection index,rheumatoid factor（RF）and anti-cyclic citrullinated peptide（CCP）antibody.Methods：The clinical data of 161 patients with RA（from March 2008 to March 2010）admitted to division of rheumatology-immunology of China-Japan Friendship Hospital were analyzed with SPSS15 software.Results：There were positive correlation between clinic data（period of disease,the number of joint tenderness and edema whether had joint destruction）and serological index（Plt,ESR,CRP,RF,anti-CCP antibody）（all P0.05）.All of the patients were divided into two groups.The anti-CCP antibody of group A were lower than 3 times of normal value and that of group B were higher than 3 times of normal value.There were significantly difference in the median period of disease,the median number of RF,the number of joint destruction between the two groups（P0.05,P0.01）.Conclusion：There are positive correlation between clinic data（period of disease,the number of joint tenderness and edema whether had joint destruction） and serological index（Plt,ESR,C-RP,RF,anti-CCP antibody）.There were significant statistical differences of disease period,RF and joint destruction between RA patients with different levels of anti-CCP antibody.For those patients who got 3 times higher anti-CCP antibody above normal value,should be managed actively to prevent irreversible joint destruction and raise survival quality.