类风湿关节炎患者高血压患病率及相关因素分析

The prevalence of hypertension and its associated factors in patients with rheumatoid arthritis

目的了解RA患者高血压患病率及其相关因素。方法入组2015年8月至2019年9月就诊于中山大学孙逸仙纪念医院风湿免疫科的RA患者,收集其人口学特征和临床资料,包括RA疾病活动、功能和影像学评估指标、合并症及既往用药。Logistic回归分析评估RA患者高血压的相关因素。结果共纳入674例RA患者,女性占82.3%(555/674),平均年龄(50±13)岁。RA患者高血压的患病率为32.9%(222/674),其后依次是血脂异常(67例,9.9%)、2型糖尿病(59例,8.8%)、高尿酸血症(43例,8.5%)、脂肪肝(54例,8.0%)、心血管疾病(42例,6.2%)和慢性肾脏病(22例,3.3%)。与非高血压组相比,高血压组的RA患者年龄大、病程长、疾病活动指标高、关节破坏严重、合并症比例高。多因素Logistic回归分析显示,在校正年龄和性别后,高尿酸血症[OR(95%CI)=1.977(1.002,3.900)]、血脂异常[OR(95%CI)=1.903(1.102,3.288)]和脂肪肝[OR(95%CI)=2.335(1.278,4.265)]是RA患者合并高血压的危险因素。结论高血压是RA患者最常见的合并症,与高尿酸血症、血脂异常及脂肪肝相关,提示应加强对RA患者高血压和心血管相关合并症的筛查与管理。

Objective To investigate the prevalence of hypertension and its associated factors in rheumatoid arthritis(RA)patients.Methods Consecutive Chinese patients with RA were recruited from August 2015 to September 2019 at Department of Rheumatology,Sun Yat-sen Memorial Hospital.Demo-graphic data and clinical data were collected including indicators of disease activity,functional assessment and radiographic assessment,comorbidities and previous medications.Logistic regression analysis was used to evaluate the related factors of hypertension in RA patients.Results There were 674 RA patients recruited with 82.3%(555/674)female and mean age(50±13)years.The prevalence rate of hypertension was 32.9%(222/674),followed by dyslipidemia(9.9%,n=67),type 2 diabetes(8.8%,n=59),hyperuricemia(8.5%,n=43),fatty liver disease(8.0%,n=54),cardiovascular disease(6.2%,n=42)and chronic kidney disease(3.3%,n=22).Compared with those without hypertension,RA patients with hypertension had advanced age with longstanding disease duration,higher disease activity indicators,worse joint destruction,and higher proportions of comorbidities.Multivariate logistic regression analysis showed that comorbidities including hyperuricemia[OR=1.977,95%CI(1.002,3.900)],dyslipidemia[OR=1.903,95%CI(1.102,3.288)]and fatty liver disease[OR=2.335,95%CI(1.278,4.265)]were risk factors of hypertension after adjustment for age and gender.Conclusion Hyperten-sion is the most common comorbidity in RA patients which is associated with comor-bidities including hyperuricemia,dyslipidemia and fatty liver disease.Detection and management of hyperten-sion and other cardiovascular disease related comorbidities in RA patients should be emphasized.