Zhang L, Hu X H, Chen C, Cai Y M, Wang Q W, Zhao J X
Department of Rheumatology & Immunology, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China.
Department of medical imaging, Peking University Shenzhen Hospital, Shenzhen 518036, Guangdong, China.
Beijing Da Xue Xue Bao Yi Xue Ban. 2021 Dec 18;53(6):1049-1054. doi: 10.19723/j.issn.1671-167X.2021.06.007.
To study the proportion of cervical spine instability in treatment-naive rheumatoid arthritis (RA) patients, to investigate the associated neck symptoms, and to analyze the clinical characteristics in treatment-naive RA patients and treated RA patients.
RA patients who underwent cervical spine X-ray imaging from the Department of Rheumatology and Immunology of Peking University Third Hospital and Peking University Shenzhen Hospital from August 2015 to October 2019 and had clinical records of medication administration were included. Clinical and laboratory data including cervical symptoms and X-ray imaging data of cervical spine were collected. The constituent ratio of cervical spine instability in treatment-naive RA patients was statistically analyzed. The clinical data and laboratory data were analyzed by -test, -test and chi square to explore the clinical characteristics of the treatment-naive RA patients with cervical instability.
Of the 408 RA patients, 105 patients were treatment-naive. Of the 105 treatment-naive patients, 82.9% (87/105) were female, with an average age of (52±14) years, the median duration of the disease was 24 months, the shortest history was 2 weeks, and the longest history was 30 years. 28.6% (30/105) of the treatment-naive RA patients showed cervical spine instability. The prevalence of cervical instability was 13.6% in the treatment-naive RA patients with disease duration less than 24 months. Among them, there were no significant differences in neck symptoms between cervical spine instability group and none cervical spine instability group. The patients with cervical spine instability had a longer duration of disease [60 (18, 180) months 16 (8, 51) months], a higher proportion of peripheral joint deformity (63.3%21.3%), and a lower hemoglobin [(106.90±21.61) g/L . (115.77±14.69) g/L]. There was no significant difference in the occurrence of cervical instability in the treatment-naive RA patients compared with treated RA patients. Among the RA patients with cervical instability, there was no statistically significant difference in the composition of each type between the patients with treatment-naive RA and patients with treated RA, except for a shorter duration of disease [120.0 (72.0, 240.0) months . 60.0 (27.0, 167.5) months].
28.6% of treatment-naive RA patients showed cervical spine instability. Cervical instability was also common in RA patients with a duration less than 24 months. There was no significant correlation between cervical instability and neck symptoms. Patients with cervical spine instability had a long-term disease, a higher proportion of peripheral joint deformity and a lower hemoglobin. Controlling the condition of RA early may help to control the progression of cervical involvement in patients with RA.
研究初治类风湿关节炎（RA）患者颈椎不稳定的比例，调查相关颈部症状，并分析初治RA患者和经治疗RA患者的临床特征。
纳入2015年8月至2019年10月在北京大学第三医院和北京大学深圳医院风湿免疫科接受颈椎X线成像且有用药临床记录的RA患者。收集包括颈部症状和颈椎X线成像数据在内的临床和实验室数据。对初治RA患者颈椎不稳定的构成比进行统计学分析。采用t检验、t检验和卡方检验对临床数据和实验室数据进行分析，以探讨颈椎不稳定的初治RA患者的临床特征。
408例RA患者中，105例为初治患者。在105例初治患者中，82.9%（87/105）为女性，平均年龄为（52±14）岁，疾病中位病程为24个月，最短病程为2周，最长病程为30年。28.6%（30/105）的初治RA患者存在颈椎不稳定。病程小于24个月的初治RA患者颈椎不稳定的患病率为13.6%。其中，颈椎不稳定组与无颈椎不稳定组的颈部症状无显著差异。颈椎不稳定患者的病程更长[60（18，180）个月对16（8，51）个月]，外周关节畸形比例更高（63.3%对21.3%），血红蛋白更低[（106.90±21.61）g/L对（115.77±14.69）g/L]。初治RA患者与经治疗RA患者相比，颈椎不稳定的发生率无显著差异。在颈椎不稳定的RA患者中，初治RA患者与经治疗RA患者各类型的构成除病程较短外[120.0（72.0，240.0）个月对6（27.0，167.5）个月]，差异无统计学意义。
28.6%的初治RA患者存在颈椎不稳定。病程小于24个月的RA患者中颈椎不稳定也很常见。颈椎不稳定与颈部症状无显著相关性。颈椎不稳定患者病程长，外周关节畸形比例高，血红蛋白低。早期控制RA病情可能有助于控制RA患者颈椎受累的进展。
