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成人人群中与炎性血管炎相关的合并症和危险因素。

Comorbidities and Risk Factors Associated with Inflammatory Vasculitis in the Adult Population.

作者信息

Millstein Ian Daniel, Kumar Arjun, Bishop Zachary, Pingol Angelo-Jesus, Sprankle Kenyon, Ai Emily, Citta Richard, Coriell Peter, Jaison Tabitha, Menon Rahul, Nowacki Joseph, Patel Sonia, Rahman Eria, Thampi Subhadra, Ziner Jonathan, Hunter Krystal, Roy Satyajeet

机构信息

Cooper Medical School of Rowan University, Camden, NJ, USA.

Department of Medicine, Cooper University Health Care, Camden, NJ, USA.

出版信息

J Prim Care Community Health. 2025 Jan-Dec;16:21501319251363020. doi: 10.1177/21501319251363020. Epub 2025 Jul 31.

Abstract

INTRODUCTION/OBJECTIVES: Inflammatory vasculitis (IV) is characterized by blood vessel inflammation, leading to vessel damage and potential organ failure. This study aimed to identify the risk factors and comorbidities in adults with IV.

METHODS

A retrospective review of adult patients receiving outpatient care was conducted. Variables were compared between IV and non-IV (NoIV) groups.

RESULTS

Among 1500 patients, 626 (41.7%) had IV. Patients in the IV group were significantly older (IV = 66.5 ± 18.8 vs NoIV = 52.9 ± 18.4 years;  < .001) and women (IV = 67.7 vs NoIV = 48.0%;  < .001). IV group had a lower prevalence of patients of White race, and higher prevalences of use of tobacco and recreational drugs. Higher frequencies of associations of comorbid medical conditions were noted in the IV group compared to NoIV group, such as hypertension (50.7 vs 29.0%;  < .001), DM (19.4 vs 10.4%;  < .001), CKD (12.1 vs 3.7%;  < .001), CAD (12.1 vs 6.2%;  < .001), CHF (5.8 vs 2.0%;  < .001), PAD (2.4 vs 0.8%;  = .013), COPD (7.8 vs 1.8%;  < .001), pulmonary fibrosis (2.4 vs 0.1%;  < .001), osteoporosis (10.4 vs 1.9%;  < .001), osteoarthritis (12.0 vs 7.1%;  = .001), GERD (21.8 vs 13.2%;  < .001), depression (14.1 vs 7.9%;  < .001), hypothyroidism (14.2 vs 8.2%;  < .001), anemia (16.9 vs 5.0%;  < .001), seizure disorder (3.0 vs 0.9%;  < .001), cancer (13.7 vs 8.5%;  = .001), asthma (15.3 vs 6.7%;  < .001), atrial fibrillation (9.6 vs 4.7%;  < .001), CVA (7.0 vs 2.5%;  < .001), SLE (2.9 vs 0.5%;  < .001), and rheumatoid arthritis (5.0 vs 0.8%;  < .001). There were significantly greater odds of IV with increasing age per year (OR 1.030, 95% CI 1.022-1.039;  < .001), recreational drug use (OR 1.953, 95% CI 1.150-3.318;  < .013), hypertension (OR 1.590, 95% CI 1.155-2.188;  = .004), DM (OR 1.621, 95% CI 1.080-2.434;  = .020), osteoarthritis-osteoporosis (OR 1.496, 95% CI 1.020-2.193;  = .039), cardiac disorders (OR 1.543, 95% CI 1.065-2.236;  = .022), pulmonary disorders (OR 3.173, 95% CI 1.663-6.054;  < .001), and rheumatological disorders (OR 3.589, 95% CI 1.780-7.236;  < .001).

CONCLUSION

IV is associated with older age, female sex, non-White race, tobacco use, recreational drug use, hypertension, DM, cardiovascular disorders (CAD, CHF, PAD, CVA), pulmonary disorders (COPD, asthma, pulmonary fibrosis), osteoporosis, osteoarthritis, SLE, and rheumatoid arthritis.

摘要

引言/目的:炎症性血管炎(IV)的特征是血管炎症,可导致血管损伤和潜在的器官衰竭。本研究旨在确定成年IV患者的危险因素和合并症。

方法

对接受门诊治疗的成年患者进行回顾性研究。比较IV组和非IV(NoIV)组之间的变量。

结果

在1500例患者中,626例(41.7%)患有IV。IV组患者年龄显著更大(IV组=66.5±18.8岁,NoIV组=52.9±18.4岁;P<0.001)且女性比例更高(IV组=67.7%,NoIV组=48.0%;P<0.001)。IV组白人患者患病率较低,烟草和消遣性药物使用患病率较高。与NoIV组相比,IV组合并内科疾病的频率更高,如高血压(50.7%对29.0%;P<0.001)、糖尿病(19.4%对10.4%;P<0.001)、慢性肾脏病(12.1%对3.7%;P<0.001)、冠心病(12.1%对6.2%;P<0.001)、心力衰竭(5.8%对2.0%;P<0.001)、外周动脉疾病(2.4%对0.8%;P=0.013)、慢性阻塞性肺疾病(7.8%对1.8%;P<0.001)、肺纤维化(2.4%对0.1%;P<0.001)、骨质疏松症(10.4%对1.9%;P<0.001)、骨关节炎(12.0%对7.1%;P=0.001)、胃食管反流病(21.8%对13.2%;P<0.001)、抑郁症(14.1%对7.9%;P<0.001)、甲状腺功能减退症(14.2%对8.2%;P<0.001)、贫血(16.9%对5.0%;P<0.001)、癫痫症(3.0%对0.9%;P<0.001)、癌症(13.7%对8.5%;P=0.001)、哮喘(15.3%对6.7%;P<0.001)、心房颤动(9.6%对4.7%;P<0.001)、脑血管意外(7.0%对2.5%;P<0.001)、系统性红斑狼疮(2.9%对0.5%;P<0.001)和类风湿关节炎(5.0%对0.8%;P<0.001)。每年年龄增长(比值比1.030,95%置信区间1.022 - 1.039;P<0.001)、消遣性药物使用(比值比1.953,95%置信区间1.150 - 3.318;P<0.013)、高血压(比值比1.590,95%置信区间1.155 - 2.188;P=0.004)、糖尿病(比值比1.621,95%置信区间1.080 - 2.434;P=0.020)、骨关节炎 - 骨质疏松症(比值比1.496,95%置信区间1.020 - 2.193;P=0.039)、心脏疾病(比值比1.543,95%置信区间1.065 - 2.236;P=0.022)、肺部疾病(比值比3.173,95%置信区间1.663 - 6.054;P<0.001)和风湿性疾病(比值比3.589,95%置信区间1.780 - 7.236;P<0.001)与IV的发生几率显著增加相关。

结论

IV与年龄较大、女性、非白人种族、烟草使用、消遣性药物使用、高血压、糖尿病、心血管疾病(冠心病、心力衰竭、外周动脉疾病、脑血管意外)、肺部疾病(慢性阻塞性肺疾病、哮喘、肺纤维化)、骨质疏松症、骨关节炎、系统性红斑狼疮和类风湿关节炎相关。

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