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基层医疗中强直性脊柱炎、银屑病关节炎和银屑病患者心血管相关合并症的患病率:一项配对回顾性队列研究

Prevalence of cardiovascular-related comorbidity in ankylosing spondylitis, psoriatic arthritis and psoriasis in primary care: a matched retrospective cohort study.

作者信息

Ahmed Nadeem, Prior James A, Chen Ying, Hayward Richard, Mallen Christian D, Hider Samantha L

机构信息

Research Institute for Primary Care and Health Sciences, Keele University, Keele, ST5 5BG, UK.

Haywood Rheumatology Centre, Haywood Hospital, Stoke-on-Trent, Staffordshire, ST6 7AG, UK.

出版信息

Clin Rheumatol. 2016 Dec;35(12):3069-3073. doi: 10.1007/s10067-016-3362-2. Epub 2016 Aug 2.

Abstract

The aim of this study is to compare the prevalence of cardiovascular (CVD)-related comorbidities in patients with ankylosing spondylitis (AS), psoriatic arthritis (PsA) or psoriasis (Ps) in UK primary care against matched cohorts. Matched retrospective cohort study used a primary care consultation database. Three cohorts were constructed using all patients with a Read code diagnosis of AS, PsA or Ps between 1999 and 2009; each cohort was then compared in a 1:4 ratio to a matched cohort. The prevalence of CVD-related comorbidities (hypertension, ischaemic heart disease, hyperlipidaemia and diabetes mellitus) were identified by the first consultation of a comorbid Read code, in those with an inflammatory condition of interest. The prevalence of CVD-related comorbidities was compared between each inflammatory cohort and their matched cohort using Fisher's exact test. Ninety-four AS, 106 PsA and 290 Ps patients were identified. Compared with matched cohorts, the most prevalent CVD-related comorbidity in patients with AS was hypertension (35 (37.2 %) vs. 96 matched (25.5 %), p = 0.03); this was also the case for PsA (41 (38.7 %) vs. 114 matched (26.9 %), p = 0.02). No differences were seen in the prevalence of other CVD-related comorbidities in those with AS, PsA or Ps compared to their matched cohorts. Our findings provide UK comparisons of CVD-related comorbidities in patients with AS, PsA and Ps alone; specifically, demonstrating increased prevalence of hypertension in AS and PsA cohorts compared to their matched cohorts. This further supports the argument for more evidence in the need for screening and intervention around CVD comorbidities in inflammatory conditions.

摘要

本研究旨在比较英国初级医疗中强直性脊柱炎(AS)、银屑病关节炎(PsA)或银屑病(Ps)患者与匹配队列中心血管疾病(CVD)相关合并症的患病率。匹配的回顾性队列研究使用了一个初级医疗咨询数据库。利用1999年至2009年间所有诊断编码为AS、PsA或Ps的患者构建了三个队列;然后将每个队列按1:4的比例与一个匹配队列进行比较。通过首次咨询合并症诊断编码,在患有相关炎症性疾病的患者中确定CVD相关合并症(高血压、缺血性心脏病、高脂血症和糖尿病)的患病率。使用Fisher精确检验比较每个炎症性队列与其匹配队列中CVD相关合并症的患病率。共识别出94例AS患者、106例PsA患者和290例Ps患者。与匹配队列相比,AS患者中最常见的CVD相关合并症是高血压(35例(37.2%) vs. 96例匹配者(25.5%),p = 0.03);PsA患者也是如此(41例(38.7%) vs. 114例匹配者(26.9%),p = 0.02)。与匹配队列相比,AS、PsA或Ps患者中其他CVD相关合并症的患病率没有差异。我们的研究结果提供了英国AS、PsA和Ps患者单独的CVD相关合并症的比较;具体而言,表明AS和PsA队列中高血压的患病率高于其匹配队列。这进一步支持了在炎症性疾病中围绕CVD合并症进行筛查和干预需要更多证据的观点。

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