Zhang J F, Ye X L, Duan M, Zhou X L, Yao Z Z, Zhao J X
Department of Rheumatology and Immunology, Peking University Third Hospital, Beijing 100191, China.
Zhonghua Yi Xue Za Zhi. 2020 Dec 22;100(47):3788-3792. doi: 10.3760/cma.j.cn112137-20200506-01439.
To compare the clinical and laboratory characteristics and therapy methods of elderly onset rheumatoid arthritis (EORA) and younger onset rheumatoid arthritis (YORA). The clinical, laboratory and therapeutic data of 481 RA patients in the Department of Rheumatology and Immunology in Peking University Third Hospital from January 2013 to December 2018 were collected and used to analyze the difference of characteristics between EORA group and YORA group, which might be useful for better diagnosis and treatment of EORA patients. Quantitative data of normal distribution were compared with test between the two groups. There were 481 patients in this cohort, of which 137(28.5%) were EORA, 344(71.5%) were YORA, with a mean age of (59±14) years (19-87 years). There were 358 females (74.4%) and 123 males (25.6%). The percentage of male patients was obviously higher in EORA group (36.5% vs 21.2%, χ(2)=12.012, 0.01), and the average disease course was obviously shorter (-7.985, 0.01). Disease Activity Score 28 (DAS28) score was higher in EORA group (5.6±1.3 vs 5.2±1.6, 2.549, 0.05), meanwhile the incidences of pleural effusion and interstitial lung disease (ILD) were higher (6.6% vs 1.7%, 29.9% vs 18.3%, respectively; χ(2)=7.550, 7.797, both 0.05). The incidences of venous thrombosis, primary hypertension, diabetes mellitus, cerebrovascular disease, coronary heart disease (CHD), peripheral atherosclerosis and cataract in EORA group were all significantly higher than those in YORA group (all 0.05). Erythrocyte sedimentation rate (ESR) and D-Dimer in EORA group were all remarkably higher (both 0.05). The rate of using glucocorticoid in EORA group was higher but the rate of using methotrexate and anti-tumor necrosis factor-α agents were lower (χ(2)=5.271, 8.407, 9.356, all 0.05). Compared to YORA group, the percentage of male patients and disease activity of EORA group are higher. The occurrence of pleural effusion, ILD, venous thrombosis, primary hypertension, diabetes mellitus, cerebrovascular disease, CHD, peripheral atherosclerosis and cataract in EORA group are higher than those in YORA group.
比较老年发病类风湿关节炎（EORA）和青年发病类风湿关节炎（YORA）的临床及实验室特征与治疗方法。收集2013年1月至2018年12月北京大学第三医院风湿免疫科481例类风湿关节炎（RA）患者的临床、实验室及治疗数据，分析EORA组与YORA组特征的差异，这可能有助于更好地诊断和治疗EORA患者。两组间正态分布的定量数据采用t检验进行比较。该队列中有481例患者，其中137例（28.5%）为EORA，344例（71.5%）为YORA，平均年龄为（59±14）岁（19 - 87岁）。有358例女性（74.4%）和123例男性（25.6%）。EORA组男性患者比例明显更高（36.5%对21.2%，χ² = 12.012，P < 0.01），且平均病程明显更短（t = -7.985，P < 0.01）。EORA组疾病活动度评分28（DAS28）更高（5.6±1.3对5.2±1.6，t = 2.549，P < 0.05），同时胸腔积液和间质性肺疾病（ILD）的发生率更高（分别为6.6%对1.7%，29.9%对18.3%；χ² = 7.550，7.797，P均< 0.05）。EORA组静脉血栓形成、原发性高血压、糖尿病、脑血管疾病、冠心病（CHD）、外周动脉粥样硬化和白内障的发生率均显著高于YORA组（P均< 0.05）。EORA组红细胞沉降率（ESR）和D - 二聚体均显著更高（P均< 0.05）。EORA组使用糖皮质激素的比例更高，但使用甲氨蝶呤和抗肿瘤坏死因子 -α制剂的比例更低（χ² = 5.271，8.407，9.356，P均< 0.05）。与YORA组相比，EORA组男性患者比例和疾病活动度更高。EORA组胸腔积液、ILD、静脉血栓形成、原发性高血压、糖尿病、脑血管疾病、CHD、外周动脉粥样硬化和白内障的发生率高于YORA组。
