2020 年第 10 期 第 15 卷

青年与老年类风湿关节炎合并冠心病患者的临床特点比较

Comparative analysis of the clinical features of rheumatoid arthritis complicated with coronary atherosclerotic heart disease between young and elderly patients

作者：王洁房丽华张成强刘晓萍崔潞萍聂婷婷李瑞

英文作者：Wang Jie Fang Lihua Zhang Chengqiang Liu Xiaoping Cui Luping Nie Tingting Li Rui

单位：山西省人民医院风湿免疫科，太原030012

英文单位：Department of Rheumatology and Immunology Shanxi Provincial People′s Hospital Taiyuan 030012 China

关键词：类风湿关节炎；冠心病（冠状动脉粥样硬化性心脏病）；青年；老年；临床特点

英文关键词：Rheumatoidarthritis;Coronaryatheroscleroticheartdisease;Youth;Elder;Clinicalfeatures

• 摘要：

• 目的 比较青年类风湿关节炎（YORA）与老年类风湿关节炎（EORA）合并冠心病（冠状动脉粥样硬化性心脏病，CHD）患者的临床特点。方法回顾性收集2016年1月至2018年12月在山西省人民医院诊断类风湿关节炎（RA）合并CHD患者129例的病历资料，按资料完整程度进行年龄分层抽样，年龄＜60岁，即YORA-CHD组60例；年龄≥60岁，即EORA-CHD组69例。比较2组患者一般资料、实验室指标和临床症状。结果 RA-CHD患者发病年龄集中于50～79岁。EORA-CHD组急性冠状动脉综合征发生率明显高于YORA-CHD组［94.2%(65/69)比78.3%(47/60)］（P=0.009）。YORA-CHD组男性、吸烟比例明显高于EORA-CHD组，发病年龄、高血压病程、糖尿病比例、吸烟指数、空腹血糖、关节肿胀数及DAS28-红细胞沉降率评分均明显低于EORA-CHD组（均P＜0.05）。结论 EORA-CHD组较YORA-CHD组急性冠状动脉综合征发生率高，与EORA-CHD多为女性、长期高血压、患有糖尿病、吸烟指数高或关节症状不易控制等因素有关。

• Objective To compare the clinical features between young onset rheumatoid arthritis (YORA) with coronary atherosclerotic heart disease（CHD) and elderly onset rheumatoid arthritis (EORA) with CHD. Methods A total of 129 RA patients complicated with CHD diagnosed in Shanxi Provincial People′s Hospital from January 2016 to December 2018 were selected. According to patients′age <60 years or ≥60 years, they were divided into the YORA-CHD group (60 cases) and the EORA-CHD group (69 cases). The general data, clinical features and laboratory indexes were compared between the two groups. Results The onset age of RA-CHD was concentrated at 50-79 years old.The incidence of acute coronary syndrome in EORA-CHD group was significantly higher than that in YORA-CHD group［94.2%(65/69) vs 78.3%(47/60)］(P=0.009). The proportion of male and smoking in YORA-CHD group were significantly higher than those in EORA-CHD group, and the onset age， duration of hypertension, proportion of diabetes, smoking index, fasting blood glucose, joint swelling number and DAS28-erythrocyte sedimentation rate score in YORA-CHD group were significantly lower than those in EORA-CHD group (all P＜0.05). Conclusion The EORA-CHD group had a higher incidence of acute coronary syndrome than the YORA-CHD group, which was related to the fact that EORA-CHD patients were mostly female, long-term hypertension, diabetes, higher smoking index or uncontrollable joint symptoms.