有阴雨天加重与无阴雨天加重的类风湿关节炎病情异同的比较

Comparison of the Similarities and Differences of Rheumatoid Arthritis Aggratated in Rainy Days and in Days without Rain

目的:探讨有阴雨天加重与无阴雨天加重的类风湿关节炎病情异同及其临床意义。方法:将河南风湿病医院类风湿关节炎数据库(HFRA数据库)中收录的409例患者按有无阴雨天加重分为阴雨天加重组和无阴雨天加重组,采用SPSS 19.0软件分析2组在关节表现及实验室检查方面的区别与联系。结果:类风湿关节炎有阴雨天加重者占患者总数的59%,且病程较无阴雨天加重组更长。关节表现上:疼痛部位(左肩、左肘、右肘、左膝、右膝关节)、畸形部位(左肘关节)、最肿的一个关节(膝关节),均为阴雨天加重组>无阴雨天加重组。13项实验室结果:红细胞沉降率、类风湿因子、抗CCP抗体、免疫球蛋白M(Ig M)、血小板计数、白细胞计数、血红蛋白、红细胞,阴雨天加重组>无阴雨天加重组。C-反应蛋白、C3,阴雨天加重组<无阴雨天加重组。C4、IgA、IgG差异无统计学意义(P>0.05)。结论:类风湿关节炎有阴雨天加重者病情更突出地反映了本病的本质:免疫功能异常、慢性滑膜炎。这可能是这类患者临床治疗难度更大的原因。

Objective：To investigate the similarities and differences of rheumatoid arthritis aggratated in rainy days and in days without rain,and its clinical significance.Methods：Four hundred and nine cases with rheumatoid arthritis recorded in the HFRA database （ database of Henan Rheumatism Hospital ） were divided into a rain-caused aggravation group and a non-rain-caused aggravation group.The software SPSS 19.0 was used to analyze the differences and relations of joint manifestation and laboratory examination of the two groups.Results：Patients in the rain-caused aggravation group accounted for 59% and their course of disease was longer than that of the other group.Joint manifestations showed that location of pain （ left shoulder, left elbow, right elbow, left knee and right knee ） ,location of deformity （ left elbow joint ） ,and the most swollen joint （ knee joint ） appeared more frequently in the rain-caused aggravation group than those in the non-rain-caused aggravation group.Thirteen laboratory results showed that erythrocyte sedimentation rate,rheumatoid factor, anti CCP antibody and immunoglobulin M （ IgM ） ,platelet count,white blood cell count,hemoglobin,red blood cell in the the rain-caused aggravation group were more than those in the non-rain-caused aggravation group.C- reactive protein and complement C3 were less in the the rain-caused aggravation group than those in the non-rain-caused aggravation group.There was no significant difference between complement C4,IgA,and IgG （ P 〉 0.05 ） .Conclusion：Aggravation of rheumatoid arthritis in rainly days reflects the nature of the disease：immune dysfunction and chronic synovitis.This may be the reason why it is difficult to treat in clinic.