类风湿关节炎呼吸系统共病的初步研究

A Preliminary Study on the Comorbidity of Respiratory System in Rheumatoid Arthritis

目的:探讨类风湿关节炎(RA)患者呼吸系统共病(共存疾病)的临床特点及相关危险因素。方法:根据ICD-10编码的电子病历首页出院诊断,统计151例住院RA患者慢性呼吸系统疾病的构成比;将RA患者分为RA呼吸系统共病(RA-RC)组和RA无呼吸系统共病(RA-NRC)组,比较一般临床资料、RA活动度、自身抗体、血液学及生化指标等在2组患者间的差异;分析其他非呼吸系统共病在2组患者的分布及其对RA-RC的影响;Logistic回归分析RA-RC的相关危险因素。结果:151例RA患者中RA-RC患者62例(41.06%),其中以间质性肺疾病最多(50.00%),其次为支气管扩张症(17.74%)、慢性支气管炎(17.74%)、肺气肿(8.06%)、慢性阻塞性肺疾病(6.45%)。与RA-NRC组比较,RA-RC组患者年龄较大、吸烟率高、病程更长、类风湿因子(RF)水平更高(P<0.05)。Logistic回归分析显示,年龄、吸烟是RA-RC的危险因素。RA-RC组非呼吸系统共病的发病率为96.77%,显著高于RA-NRC组(77.53%),差异有统计学意义(P<0.05);2组间非呼吸系统共病的种类也存在一定差别。结论:RA-RC患病率高,年龄与吸烟可能是其危险因素;共存非呼吸系统共病也可能对RA-RC的发生具有影响。

Objective:To investigate the clinical features and related risk factors of respiratory comorbidities(coexisting diseases)in patients with rheumatoid arthritis(RA).Methods:Based on the ICD-10-encoded electronic medical record first page discharge diagnosis,the composition ratio of chronic respiratory diseases in 151 RA patients was counted;RA patients were divided into RA respiratory comorbidity(RA-RC)group and RA non-respiratory system comorbidity(RA-NRC)group,the differences in general clinical data,RA activity,autoantibodies,hematology,and biochemical indices between the two groups of patients;the distribution of other non-respiratory comorbidities in the two groups of patients and their comparison RA-RC effects;Logistic regression analysis of RA-RC related risk factors.Results:Of the 151 patients with RA,62(41.06%)had RA-RC,with interstitial lung disease being the most common(50.00%),followed by bronchiectasis(17.74%),chronic bronchitis(17.74%),and lungs.Emphysema(8.06%),chronic obstructive pulmonary disease(6.45%).Compared with RA-NRC group,patients in RA-RC group had older age,higher smoking rate,longer duration,and higher level of rheumatoid factor(RF)(P<0.05).Logistic regression analysis showed that age and smoking were risk factors for RA-RC.The incidence of non-respiratory comorbidity in RA-RC patients was 96.77%,which was significantly higher than that in RA-NRC group(77.53%)(P<0.05).There were also non-respiratory comorbidities between the two groups.Conclusion:The prevalence of RA-RC is high,age and smoking may be risk factors;coexistence of non-respiratory comorbidities may also have an impact on the occurrence of RA-RC.