类风湿关节炎患者远端指间关节骨侵蚀的频率和危险因素分析:一项横断面研究。

IF 1 4区 医学 Q4 RHEUMATOLOGY
Acta reumatologica portuguesa Pub Date : 2021-07-01
Satoshi Ikemura, Satoshi Hagio, Yukio Akasaki, Toshifumi Fujiwara, Hidetoshi Tsushima, Yasuharu Nakashima
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引用次数: 0

摘要

目的:很少有报道关注类风湿性关节炎(RA)患者的远端指间关节(DIP)。本研究的目的是评估DIP关节骨侵蚀的频率,并确定与其畸形相关的因素。方法:本研究回顾了204例RA患者的手部x线片。根据DIP关节有无骨侵蚀情况,将患者分为DIP阳性组和DIP阴性组。此外,还对腕关节、掌指关节(MP)、拇指指间关节(IP)和近端指间关节(PIP)进行了评估。临床变量如年龄、性别、体重指数、病程、疾病活动度(DAS28-CRP)和药物使用情况进行了调查。结果:DIP关节的影像学表现,DIP阳性组32例(15.7%),DIP阴性组172例(84.3%)。dip阳性组的平均年龄、病程、DAS28-CRP和皮质类固醇使用率均显著高于dip阴性组(p分别为0.0031、0.0062、0.0342和0.0011)。放射学上,dip阳性组的腕部、MP、拇指IP和PIP关节合并骨侵蚀比dip阴性组明显更常见(所有四个关节均p < 0.01)。多因素分析显示,高龄、病程长、PIP关节存在影像学骨侵蚀与DIP关节骨侵蚀独立相关(p值分别为0.0480、0.0307和0.0021)。结论:RA患者可在DIP关节处观察到骨侵蚀,这些病例经常出现其他手指关节的骨侵蚀,如PIP关节。此外,在一些RA患者中,由于疾病活动不受控制,在RA发病后不久可观察到骨侵蚀。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Frequency and risk factor analyses of bone erosion of the distal interphalangeal joint in patients with rheumatoid arthritis: a cross-sectional study.

Aims: Few reports have focused on the distal interphalangeal (DIP) joint in patients with rheumatoid arthritis (RA). The purposes of this study were to evaluate the frequency of bone erosion of the DIP joint, and to determine the factors associated with its deformity.

Methods: This study reviewed 204 patients with RA in whom radiographs of hands were obtained. According to the presence/absence of bone erosion of the DIP joint, patients were divided into two groups (DIP-positive and DIP-negative groups). Additionally, wrist, metacarpal phalangeal (MP), thumb interphalangeal (IP), and proximal interphalangeal (PIP) joints were evaluated. Clinical variables such as age, sex, body mass index, disease duration, disease activity (DAS28-CRP), and drug use were investigated.

Results: Regarding the radiological findings of the DIP joint, 32 patients (15.7%) were allocated to the DIP-positive group and 172 patients (84.3%) to the DIP-negative group. The mean age, disease duration, DAS28-CRP, and the rate of corticosteroids usage were significantly higher in the DIP-positive than in the DIP-negative group (p = 0.0031, 0.0062, 0.0342, and 0.0011, respectively). Radiologically, concomitant bone erosions of the wrist, MP, thumb IP, and PIP joints were significantly more common in the DIP-positive than in the DIP-negative group (p < 0.01 for all four joints). Multivariate analysis demonstrated that advanced age, long disease duration, and the presence of radiological bone erosion of the PIP joint were independently associated with bone erosion of the DIP joint (p = 0.0480, 0.0307, and 0.0021, respectively). Accordingly, in patients with DIP erosions, mean DAS28-CRP was significantly higher in patients with <5 years (n = 10) than in those with ≥5 years of disease duration (n = 22, p = 0.0088).

Conclusions: Bone erosion can be observed at the DIP joint in patients with RA, and these cases frequently shows bone erosions of other finger joints, such as PIP joint. In addition, bone erosion can be observed soon after the onset of RA caused by uncontrolled disease activity in some patients with RA.

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来源期刊
Acta reumatologica portuguesa
Acta reumatologica portuguesa 医学-风湿病学
自引率
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0
审稿时长
>12 weeks
期刊介绍: Acta Reumatólogica Portuguesa is a scientific peer reviewed journal covering all aspects of rheumatic diseases and related to Rheumatology. The journal publishes original articles, reviews, clinical cases, images in rheumatology, letters to the editor and clinical teaching (e.g. guidelines and clinical protocols). Published since 1973, Acta Reumatológica Portuguesa is the official scientific publication of the Portuguese Society of Rheumatology, a non-profit organization that promotes the knowledge and investigation of rheumatic diseases and the development of Rheumatology.
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