Department of Rheumatology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, 123 Ta-Pei Road, Niao-Sung Dist. Kaohsiung 833, Kaohsiu, Taiwan.
BMC Musculoskelet Disord. 2023 May 30;24(1):438. doi: 10.1186/s12891-023-06521-8.
To evaluate the factors to predict subclinical inflammation of wrist joints in patients with RA who are in clinical remission or low disease activity.
Gray scale and power Doppler ultrasound were performed on the dorsal radio-lunate of both wrists. The presence of synovitis, comorbidities, and use of disease modifying anti-rheumatic drugs were recorded. A Multivariable forward logistical regression model was used to identify factors associated with subclinical inflammation.
There were 1248 patients (1010 females, 238 males; mean age: 60.0 ± 10.5 years ). 57.4% of patients in complete remission and low disease activity had sonographic inflammation. Multivariable forward logistic regression analysis indicated that male sex, smoking are positively associated with inflammation and that age, alcohol consumption, and use of methotrexate, glucocorticoid, or a biological therapy are negatively associated with inflammation. Use of biological agents decreased the risk of inflammation by 40.9%.
There was evidence of subclinical inflammation in most patients who were in low or no disease activity, those with biological therapy had lower risk of subclinical inflammation.
评估预测 RA 患者临床缓解或低疾病活动度时腕关节亚临床炎症的因素。
对双侧腕背侧桡尺关节进行灰阶和能量多普勒超声检查。记录滑膜炎、合并症和使用改善病情抗风湿药物的情况。采用多变量向前逻辑回归模型来确定与亚临床炎症相关的因素。
共纳入 1248 例患者（1010 例女性，238 例男性；平均年龄：60.0±10.5 岁）。57.4%处于完全缓解和低疾病活动度的患者存在超声滑膜炎。多变量向前逻辑回归分析表明，男性、吸烟与炎症呈正相关，而年龄、饮酒以及使用甲氨蝶呤、糖皮质激素或生物制剂与炎症呈负相关。使用生物制剂使炎症风险降低了 40.9%。
大多数处于低疾病活动度或无疾病活动度的患者存在亚临床炎症，使用生物制剂的患者亚临床炎症风险较低。
