类风湿关节炎患者在长期随访期间发生的不良事件

I. S. Dydykina, P. O. Postnikova, P. S. Kovalenko, S. I. Glukhova, A. M. Lila
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At baseline and in dynamics, standard laboratory and X-ray examinations were carried out. Results and discussion. There was a decrease in the DAS28 index and the number of patients with high or moderate activity [from 82 (85 %) to 67 (69 %), p = 0.02] against the background of an increase in the number of patients with remission or low activity [from 15 (15 %) to 30 (31 %), p = 0.012], at the same time there was an increase in the number of patients with ankylosis of joints [from 25 (24 %) to 41 (40 %), p = 0.017], functional class III [from 3 (3 %) to 15 (15 %), p=0.004], concomitant diseases [from 81 (79 %) to 94 (91 %), p = 0.015], thrombotic events [from 7 (7 %) to 18 (17 %), p = 0.027]. In 43 (42 %) patients 55 low-energy fractures were registered, in 24 (56 %) of them fractures occurred for the first time and in 19 (44 %) – repeatedly. Conclusion. 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摘要

类风湿关节炎(RA)患者的合并症和不良事件对RA的预后(放射学进展、关节功能、低能骨折的发生、血栓事件等)产生负面影响。目的:研究长期前瞻性随访期间RA患者发生的合并症和不良事件的结构,研究这些事件对患者功能状态和工作能力的动态影响。材料和方法。Аn一项开放、队列、前瞻性、长期非干预性研究,纳入103名确诊为RA的女性(平均年龄63.5±8.3岁,随访期8,5±1,3年)。在基线和动力学中,进行了标准的实验室和x射线检查。结果和讨论。DAS28指数降低,患者的数量高或温和的活动(从82年(85%),67年(69%),p = 0.02)的背景下,缓解患者的数量的增加或低活动(从15 (15%)30 (31%),p = 0.012),同时有越来越多的患者关节僵硬的关节(从25(24%)41例(40%),p = 0.017),功能第三类(从3 (3%)15 (15%),p = 0.004),伴发疾病[81例(79%)至94例(91%),p = 0.015],血栓形成事件[7例(7%)至18例(17%),p = 0.027]。43例(42%)患者发生55例低能性骨折,其中24例(56%)为首次骨折,19例(44%)为多次骨折。结论。前瞻性长期随访显示,尽管RA活动降低,但出现强直、关节功能障碍及伴随疾病的患者数量增加。在合并疾病的结构中,冠心病和动脉高血压占主导地位。注意到血栓事件的高发,反复和首次低能骨折。残疾病人的数量增加了五倍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Adverse events that occurred in patients with rheumatoid arthritis during long-term follow-up
Comorbid diseases and adverse events that occur in patients with rheumatoid arthritis (RA) negatively affect the outcomes of RA (radiological progression, joint function, the occurrence of low-energy fractures, thrombotic events, etc.). Objective: to study the structure of comorbid diseases and adverse events that occurred in patients with RA over the period of long-term prospective follow-up, to study the impact of these events on the dynamics of the functional status and working capacity of patients. Materials and methods. Аn open, cohort, prospective, long-term non-interventional study included 103 women with a definite diagnosis of RA (mean age 63.5 ± 8.3 years, follow-up period 8,5 ± 1,3 years). At baseline and in dynamics, standard laboratory and X-ray examinations were carried out. Results and discussion. There was a decrease in the DAS28 index and the number of patients with high or moderate activity [from 82 (85 %) to 67 (69 %), p = 0.02] against the background of an increase in the number of patients with remission or low activity [from 15 (15 %) to 30 (31 %), p = 0.012], at the same time there was an increase in the number of patients with ankylosis of joints [from 25 (24 %) to 41 (40 %), p = 0.017], functional class III [from 3 (3 %) to 15 (15 %), p=0.004], concomitant diseases [from 81 (79 %) to 94 (91 %), p = 0.015], thrombotic events [from 7 (7 %) to 18 (17 %), p = 0.027]. In 43 (42 %) patients 55 low-energy fractures were registered, in 24 (56 %) of them fractures occurred for the first time and in 19 (44 %) – repeatedly. Conclusion. As the prospective long-term follow-up shows, despite the decrease in RA activity, the number of patients with ankylosis, joint dysfunction and concomitant diseases increased. In the structure of concomitant diseases coronary heart disease and arterial hypertension dominated. A high incidence of thrombotic events, repeated and first-time low-energy fractures was noted. The number of disabled patients increased fivefold.
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