一组埃及类风湿关节炎患者中的早发型和晚发型类风湿关节炎（YORA和EORA）模式
Pattern of Young and Old Onset Rheumatoid Arthritis (YORA and EORA) Among a Group of Egyptian Patients with Rheumatoid Arthritis.
作者信息
El-Labban Abdou S, Omar Hanaa A S Abo, El-Shereif Rawhya R, Ali Fatma, El-Mansoury Tarek M
机构信息
Department of Rheumatology and Rehabilitation, Faculty of Medicine, Minia University, Egypt.
出版信息
Clin Med Insights Arthritis Musculoskelet Disord. 2010 May 20;3:25-31. doi: 10.4137/cmamd.s4935.
OBJECTIVE
Rheumatoid arthritis (RA) differs depending on the age of disease onset. The differences between EORA and YORA are important because they have clinical and therapeutic implications.
METHOD
1185 patients were ranked after classification according to age at onset of the disease into YORA I (16-40 years), YORA II (41-60 years) and EORA >60 years. All patients groups were compared, based on disease duration, disease activity, severity parameters and drug history.
RESULTS
YORA I included 298 patients, 28.85% were males, with mean age of 29.4 ± 6 years and disease duration 4 ± 3.3 y, YORA II included 539 patients, 33.77% males, age 49.7 ± 6.1 y and disease duration 6.5 ± 5.6 y. EORA included 348 RA patients 40.5% males, age 67.1 ± 6.6 y, disease duration 9.95 ± 7.2 y. Activity was increased in EORA compared to YORA I and YORA II, while severity decreased in EORA. ESR, CRP and degree of anemia were higher in EORA. RF titer was higher in YORA. Small joints of the hands and feet were more involved in YORA, while, large joints in EORA. Rheumatoid nodules were increased in YORA I than EORA P = 0.04. Polymyalgia rheumatica was exclusively present in EORA group 25 patients 7.2%. Methotrexate was used in both YORA and EORA, with a higher mean of dosage in YORA than EORA. Multiple DMARDs in EORA was 57.9%, and biologics in 0.8% was which was significantly lower compared with YORA I, 86.3% and 1.7%, with P = 0.001.
CONCLUSION
EORA has more active and less disabling and affects more males than YORA. The use of biologic therapy and combination DMARD therapy was less in EORA.
目的
类风湿关节炎（RA）因发病年龄不同而有所差异。早发型类风湿关节炎（EORA）和晚发型类风湿关节炎（YORA）之间的差异很重要，因为它们具有临床和治疗意义。
方法
1185例患者根据发病年龄分为YORA I组（16 - 40岁）、YORA II组（41 - 60岁）和EORA组（>60岁），分类后进行排序。基于疾病持续时间、疾病活动度、严重程度参数和用药史对所有患者组进行比较。
结果
YORA I组包括298例患者，男性占28.85%，平均年龄29.4±6岁，疾病持续时间4±3.3年；YORA II组包括539例患者，男性占33.77%，年龄49.7±6.1岁，疾病持续时间6.5±5.6年。EORA组包括348例类风湿关节炎患者，男性占40.5%，年龄67.1±6.6岁，疾病持续时间9.95±7.2年。与YORA I组和YORA II组相比，EORA组的疾病活动度增加，而严重程度降低。EORA组的红细胞沉降率（ESR）、C反应蛋白（CRP）和贫血程度更高。YORA组的类风湿因子（RF）滴度更高。YORA组中手和脚的小关节受累更多，而EORA组中大型关节受累更多。YORA I组的类风湿结节比EORA组增加，P = 0.04。风湿性多肌痛仅出现在EORA组，共25例患者，占7.2%。YORA组和EORA组均使用甲氨蝶呤，YORA组的平均用药剂量高于EORA组。EORA组联合使用多种改善病情抗风湿药（DMARDs）的比例为57.9%，使用生物制剂的比例为0.8%，与YORA I组相比显著更低，YORA I组使用多种DMARDs的比例为86.3%，使用生物制剂的比例为1.7%，P = 0.001。
结论
与YORA相比，EORA的疾病活动度更高、致残性更低，且男性患者更多。EORA组使用生物治疗和联合DMARD治疗的比例更低。
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