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Ann Rheum Dis：类风湿关节炎增加深静脉血栓风险

2013-08-19 MedSci MedSci原创

静脉血栓栓塞
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有关RA和深静脉血栓（DVT）及肺栓塞（PE）相关性的研究缺乏。鉴于这种情况，来自台湾国立医科大学临床医学研究所的Wei-Sheng Chung博士等人进行了一项前瞻性的队列研究。研究结果发表在2013年8月的Ann Rheum Dis（《风湿病年鉴》）上，研究结果证实，相对普通人群，RA患者的DVT和PE发病风险增加。 　　研究者将1998到2008年间全台湾地区人口纳

有关RA和深静脉血栓（DVT）及肺栓塞（PE）相关性的研究缺乏。鉴于这种情况，来自台湾国立医科大学临床医学研究所的Wei-Sheng Chung博士等人进行了一项前瞻性的队列研究。研究结果发表在2013年8月的Ann Rheum Dis（《风湿病年鉴》）上，研究结果证实，相对普通人群，RA患者的DVT和PE发病风险增加。

Table 1

Demographic characteristics and comorbidity in patients with and without rheumatoid arthritis

 

Variable Rheumatoid arthritis p Value
No Yes
n=116 952 n=29 238
Sex n (%) n (%)
 Female 90 012 (77.0) 22 503 (77.0) 0.99
 Male 26 940 (23.0) 6735 (23.0)
Age, mean (SD) 52.0 (15.9) 52.4 (15.6) <0.0001*
Stratify age
 <50 48 904 (41.8) 12 226 (41.8) 0.99
 50–65 42 164 (36.1) 10 541 (36.1)
 65+ 25 884 (22.1) 6471 (22.1)
Comorbidity
 Atrial fibrillation 653 (0.56) 189 (0.65) 0.08
 Hypertension 8435 (7.21) 2663 (9.11) <0.0001
 Diabetes 5159 (4.41) 1638 (5.61) <0.0001
 Hyperlipidaemia 2239 (1.91) 705 (2.41) <0.0001
 CVA 3506 (3.00) 822 (2.81) 0.09
 Heart failure 1113 (0.95) 478 (1.63) <0.0001
 Lower leg fracture or surgery 1582 (1.35) 542 (1.85) <0.0001
 Cancer 1899 (1.62) 464 (1.59) 0.66

 

  •  

Figure 1  Failure functions of deep vein thrombosis (DVT) in patients with rheumatoid arthritis and comparison patients.

研究者将1998到2008年间全台湾地区人口纳入研究，并随访至2010年底。用台湾全民健康保险研究资料库（NHIRD）中的大病注册确定RA患者。从普通人群中随机选择年龄（每5岁为一阶段）、性别及所在年份相匹配者为对照队列。用Cox比例风险回归模型分析包括性别、年龄和合并症在内的DVT和PE的发病风险。

Figure 2 Failure functions of pulmonary embolism (PE) in patients with rheumatoid arthritis and comparison patients.

队列中共纳入23.74百万人口，其中有29238名RA患者（77%为女性，平均年龄为52.4岁）、对照116952人，分别随访193753和792941人年（每年随访患者次数）。经年龄、性别和并发症校正后，RA患者对比非RA患者其DVT和PE的发病风险分别为3.36倍和 2.07倍。

这项前瞻性队列研究证实，相对普通人群，RA患者的DVT和PE发病风险增加。

原始出处：

Chung WS, Peng CL, Lin CL, Chang YJ, Chen YF, Chiang JY, Sung FC, Kao CH.Rheumatoid arthritis increases the risk of deep vein thrombosis and pulmonary thromboembolism: a nationwide cohort study.Ann Rheum Dis. 2013 Aug 13. doi: 10.1136/annrheumdis-2013-203380.

      

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    2014-05-30 cmj8wellington

    #Dis#

    0

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    2014-07-12 xue8602

    #静脉血#

    0

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    2014-07-17 fusion

    #静脉#

    0

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    2013-08-21 lmm397

    #关节炎#

    0

  5. [GetPortalCommentsPageByObjectIdResponse(id=2011844, encodeId=7725201184447, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Fri May 30 22:10:00 CST 2014, time=2014-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955185, encodeId=ad9d19551858d, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Sat Jul 12 05:10:00 CST 2014, time=2014-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697177, encodeId=91c6169e17724, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Thu Jul 17 18:10:00 CST 2014, time=2014-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265154, encodeId=9bc3126515406, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Wed Aug 21 13:10:00 CST 2013, time=2013-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333738, encodeId=dfdd1333e38bb, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Wed Aug 21 13:10:00 CST 2013, time=2013-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1597212, encodeId=85f9159e21206, content=<a href='/topic/show?id=fa1710082017' target=_blank style='color:#2F92EE;'>#风湿关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100820, encryptionId=fa1710082017, topicName=风湿关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=456818510265, createdName=xuruicheng, createdTime=Wed Aug 21 13:10:00 CST 2013, time=2013-08-21, status=1, ipAttribution=)]
    2013-08-21 ms4964546379600229

    #类风湿#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=2011844, encodeId=7725201184447, content=<a href='/topic/show?id=7d69598468' target=_blank style='color:#2F92EE;'>#Dis#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=5984, encryptionId=7d69598468, topicName=Dis)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=c689267, createdName=cmj8wellington, createdTime=Fri May 30 22:10:00 CST 2014, time=2014-05-30, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1955185, encodeId=ad9d19551858d, content=<a href='/topic/show?id=0aeb991e44c' target=_blank style='color:#2F92EE;'>#静脉血#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99174, encryptionId=0aeb991e44c, topicName=静脉血)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d139492, createdName=xue8602, createdTime=Sat Jul 12 05:10:00 CST 2014, time=2014-07-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1697177, encodeId=91c6169e17724, content=<a href='/topic/show?id=f2399910109' target=_blank style='color:#2F92EE;'>#静脉#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=21, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99101, encryptionId=f2399910109, topicName=静脉)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=0bc129907796, createdName=fusion, createdTime=Thu Jul 17 18:10:00 CST 2014, time=2014-07-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1265154, encodeId=9bc3126515406, content=<a href='/topic/show?id=57a53011364' target=_blank style='color:#2F92EE;'>#关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Wed Aug 21 13:10:00 CST 2013, time=2013-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1333738, encodeId=dfdd1333e38bb, content=<a href='/topic/show?id=5306e6164b6' target=_blank style='color:#2F92EE;'>#类风湿#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=29, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=76164, encryptionId=5306e6164b6, topicName=类风湿)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/DYAIOgq83eq2AGzrugK9ZUjU3eJxzM901ophWib0xJDrSicy49ibWl3zB5pbDto7eoR6tnzwOiaKdbq1a8PcbYFFrw/132, createdBy=6ff22500098, createdName=ms4964546379600229, createdTime=Wed Aug 21 13:10:00 CST 2013, time=2013-08-21, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1597212, encodeId=85f9159e21206, content=<a href='/topic/show?id=fa1710082017' target=_blank style='color:#2F92EE;'>#风湿关节炎#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=100820, encryptionId=fa1710082017, topicName=风湿关节炎)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=456818510265, createdName=xuruicheng, createdTime=Wed Aug 21 13:10:00 CST 2013, time=2013-08-21, status=1, ipAttribution=)]
    2013-08-21 xuruicheng

    #风湿关节炎#

    0