[Incidence and risk factors of deep vein thrombosis in patients with rheumatoid arthritis].

Q3 Medicine
北京大学学报(医学版) Pub Date : 2024-04-18
Xiaofei Tang, Yonghong Li, Qiuling Ding, Zhuo Sun, Yang Zhang, Yumei Wang, Meiyi Tian, Jian Liu
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引用次数: 0

Abstract

Objective: To investigate the incidence and risk factors of deep vein thrombosis (DVT) in patients with rheumatoid arthritis (RA).

Methods: The clinical data of RA patients who were hospi-talized in the Department of Rheumatology and Immunology of Aerospace Center Hospital from May 2015 to September 2021 was retrospectively analyzed, including demographic characteristics, concomitant diseases, laboratory examinations (blood routine, biochemistry, coagulation, inflammatory markers, rheumatoid factor, antiphospholipid antibodies and lupus anticoagulant, etc.) and treatment regimens. The patients were compared according to the presence or absence of DVT, and the t test, Mann-Whitney U test or Chi-square test were applied to screen for relevant factors for DVT, followed by Logistic regression analysis to determine risk factors for DVT in patients with RA.

Results: The incidence of DVT in the RA patients was 9.6% (31/322); the median age of RA in DVT group was significantly older than that in non-DVT group [64 (54, 71) years vs. 50 (25, 75) years, P < 0.001]; the level of disease activity score using 28 joints (DAS28)-erythrocyte sedimentation rate (ESR) in DVT group was higher than that in non-DVT group [5.2 (4.5, 6.7) vs. 4.5(4.5, 5.0), P < 0.001]; the incidence of hypertension, chronic kidney disease, fracture or surgery history within 3 months, and varicose veins of the lower extremities in DVT group was higher than that in non-DVT group (P < 0.001). The levels of hemoglobin and albumin in DVT group were significantly lower than that in non-DVT group (P=0.009, P=0.004), while the D-dimer level and rheumatoid factor positive rate in DVT group were significantly higher than that in non-DVT group (P < 0.001). The use rate of glucocorticoid in DVT group was higher than that in non-DVT group (P=0.009). Logistic regression analysis showed that the age (OR=1.093, P < 0.001), chronic kidney disease (OR=7.955, P=0.005), fracture or surgery history within 3 months (OR=34.658, P=0.002), DAS28-ESR (OR=1.475, P=0.009), and the use of glucocorticoid (OR=5.916, P=0.003) were independent risk factors for DVT in RA patients.

Conclusion: The incidence of DVT in hospitalized RA patients was significantly increased, in addition to traditional factors, such as age and chronic kidney disease, increased DAS28-ESR level and the use of glucocorticoid were also independent risk factors for DVT.

[类风湿性关节炎患者深静脉血栓形成的发病率和风险因素]。
目的研究类风湿性关节炎(RA)患者深静脉血栓形成(DVT)的发生率和风险因素:回顾性分析2015年5月至2021年9月在航天中心医院风湿免疫科住院治疗的RA患者的临床资料,包括人口学特征、伴随疾病、实验室检查(血常规、生化、凝血、炎症指标、类风湿因子、抗磷脂抗体、狼疮抗凝物等)和治疗方案。根据有无深静脉血栓形成对患者进行比较,采用t检验、曼-惠特尼U检验或卡方检验筛选深静脉血栓形成的相关因素,然后采用Logistic回归分析确定RA患者深静脉血栓形成的危险因素:RA患者深静脉血栓的发生率为9.6%(31/322);深静脉血栓组RA患者的中位年龄明显大于非深静脉血栓组[64(54,71)岁 vs. 50(25,75)岁,P <0.001];深静脉血栓组患者的28个关节疾病活动度评分(DAS28)-红细胞沉降率(ESR)水平高于非深静脉血栓组[5.2 (4.5, 6.7) vs. 4.5(4.5, 5.0),P < 0.001];DVT 组高血压、慢性肾病、3 个月内骨折或手术史、下肢静脉曲张的发生率高于非 DVT 组(P < 0.001)。深静脉血栓组的血红蛋白和白蛋白水平明显低于非深静脉血栓组(P=0.009,P=0.004),而深静脉血栓组的D-二聚体水平和类风湿因子阳性率明显高于非深静脉血栓组(P<0.001)。深静脉血栓组使用糖皮质激素的比例高于非深静脉血栓组(P=0.009)。逻辑回归分析显示,年龄(OR=1.093,P<0.001)、慢性肾病(OR=7.955,P=0.005)、3个月内骨折或手术史(OR=34.658,P=0.002)、DAS28-ESR(OR=1.475,P=0.009)和使用糖皮质激素(OR=5.916,P=0.003)是RA患者深静脉血栓的独立危险因素:结论:住院RA患者深静脉血栓的发生率明显升高,除了年龄、慢性肾病等传统因素外,DAS28-ESR水平升高和使用糖皮质激素也是深静脉血栓的独立危险因素。
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来源期刊
北京大学学报(医学版)
北京大学学报(医学版) Medicine-Medicine (all)
CiteScore
0.80
自引率
0.00%
发文量
9815
期刊介绍: Beijing Da Xue Xue Bao Yi Xue Ban / Journal of Peking University (Health Sciences), established in 1959, is a national academic journal sponsored by Peking University, and its former name is Journal of Beijing Medical University. The coverage of the Journal includes basic medical sciences, clinical medicine, oral medicine, surgery, public health and epidemiology, pharmacology and pharmacy. Over the last few years, the Journal has published articles and reports covering major topics in the different special issues (e.g. research on disease genome, theory of drug withdrawal, mechanism and prevention of cardiovascular and cerebrovascular diseases, stomatology, orthopaedic, public health, urology and reproductive medicine). All the topics involve latest advances in medical sciences, hot topics in specific specialties, and prevention and treatment of major diseases. The Journal has been indexed and abstracted by PubMed Central (PMC), MEDLINE/PubMed, EBSCO, Embase, Scopus, Chemical Abstracts (CA), Western Pacific Region Index Medicus (WPR), JSTChina, and almost all the Chinese sciences and technical index systems, including Chinese Science and Technology Paper Citation Database (CSTPCD), Chinese Science Citation Database (CSCD), China BioMedical Bibliographic Database (CBM), CMCI, Chinese Biological Abstracts, China National Academic Magazine Data-Base (CNKI), Wanfang Data (ChinaInfo), etc.
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