1468例类风湿关节炎患者终点事件发生情况队列研究

目的 采用队列研究方法，随访安徽中医药大学第一附属医院类风湿关节炎（rheumatoid arthritis，RA）出院患者终点事件发生情况，探讨其终点事件发生的相关因素。方法 纳入安徽中医药大学第一附属医院2012年1月至2016年6月期间诊断为RA患者的病例，调取并记录RA患者的一般资料，采用电话随访方式，随访并记录出院患者中医药使用情况（根据RA患者服药时间分为非暴露组、低暴露组、中暴露组和高暴露组）、终点事件发生情况，调取随访成功RA患者首次入院的实验室指标，采用多元Logistic回归分析法分析各因素与RA患者终点事件发生的相关性。结果 共纳入1 812例RA患者，随访成功1 468例，随访终点事件有80例。全因死亡的影响因素是中医药暴露强度，年龄、抗环瓜氨酸多肽抗体能够增加病死率；再发入院的影响因素是中医药暴露强度，血沉、超氧化物歧化酶、血小板可以增加再发入院的发生率；关节外病变的影响因素是中医药暴露强度、改善病情的抗风湿药，年龄、抗环瓜氨酸多肽抗体会增加关节外病变的风险；手术治疗的影响因素是中医药暴露强度。结论 中医药干预是RA患者终点事件发生的相关因素，且干预强度越大，终点事件发生率越低。

Outcome Events of 1 468 Patients with Rheumatoid Arthritis: A Cohort Study

Objective To investigate the incidence of outcome events of patients with rheumatoid arthritis (RA) in The First Affiliated Hospital of Anhui University of Chinese Medicine using a cohort study, as well as related factors for the development of outcome events. Methods The patients who were diagnosed with RA in The First Affiliated Hospital of Anhui University of Chinese Medicine from January 2012 to June 2016 were enrolled, and their general data were collected. Telephone follow-up was performed to record the use of traditional Chinese medicine (TCM) (according to the medication time, the patients were divided into non-exposure group and low-, medium-, and high-exposure groups) and the incidence of outcome events. The laboratory markers during first admission were collected for RA patients who were followed up successfully, and a logistic regression analysis was performed to investigate the association between factors and the incidence of outcome events in RA patients. Results A total of 1 812 RA patients were enrolled, among whom 1 468 patients were followed up successfully, and 80 patients experienced outcome events. TCM exposure was an influencing factor for all-cause death, and age and anti-cyclic citrullinated peptide antibody (anti-CCP Ab) increased the mortality rate. TCM exposure was also an influencing factor for recurrence and readmission, and erythrocyte sedimentation rate, superoxide dismutase, and platelet count increased the incidence rate of recurrence and readmission. TCM exposure and anti-rheumatic drugs were influencing factors for extra-articular lesions, and age and anti-CCP Ab increased the risk of extra-articular lesions. TCM exposure was an influencing factor for surgical treatment. Conclusion TCM intervention is an influencing factor for outcome events in RA patients, and the incidence of outcome events decreases with the increasing intensity of TCM exposure.