首页|真实世界中医治疗下类风湿关节炎合并间质性肺病的特征分析

真实世界中医治疗下类风湿关节炎合并间质性肺病的特征分析

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目的 基于真实世界类风湿关节炎(rheumatoid arthritis,RA)临床队列探讨中医药干预下RA合并间质性肺病(interstitial lung disease,ILD)的临床特征及影响因素.方法 本研究选取2019年10月至2023年7月在"中国中医风湿病注册研究信息平台"注册的RA患者,采用回顾性巢式病例对照研究,根据观察截止时RA患者是否合并ILD分组,收集比较两组患者基线人口学特征、病情评估、实验室检查、中医证候、处方等资料,并探讨RA-ILD的相关影响因素.结果 共纳入4 068例RA患者,其中RA-ILD组678例,RA-nonILD组3 390例.湿热痹阻证是RA-ILD的主要证候类型(33.2%),且RA-ILD多兼瘀血阻络证、痰瘀痹阻证.Logistics分析表明年龄≥50岁、类风湿因子(rheumatoid factors,RF)高滴度阳性、抗环瓜氨酸肽(cyclic citrullinated peptide,CCP)抗体高滴度阳性、晨僵、乏力、白细胞升高、高密度脂蛋白降低、血糖升高是RA-ILD的相关危险因素,使用中药、中药+西药是RA-ILD的相关保护因素.结论 针对高龄伴晨僵、乏力,RF、抗CCP抗体高滴度阳性,白细胞升高、高密度脂蛋白降低、血糖升高的RA患者应尽早开展定期肺功能检查,早期识别RA-ILD的发生风险,同时应重视中药和中西药在RA-ILD发生发展中的保护作用.
Analysis of Characteristics for Rheumatoid Arthritis Combined with Interstitial Lung Disease Under the Treatment of Traditional Chinese Medicine in Real World
Objective To investigate the clinical features and influencing factors of rheumatoid arthritis with interstitial lung disease(RA-ILD)under the intervention of traditional Chinese medicine(TCM)based on the real-world clinical cohort of RA.Methods Based on"CERTAIN"platform,the clinical data of RA patients registered from October 2019 to July 2023 were selected and grouped according to whether RA patients had ILD at the cut-off date.A retrospective nested case-control study was conducted to collect and compare baseline demographic characteristics,disease assessment,laboratory tests,traditional Chinese medicine syndromes,prescriptions,and other data between two groups of patients.Then we explored the relevant factors of RA-ILD.Results A total of 4 068 RA patients were enrolled,including 678 in the RA-ILD group and 3 390 in the RA-nonILD group.Syndrome of stagnant dampness-heat was the main type of RA-ILD(33.2%),and RA-ILD was mostly accompanied by the syndrome of static blood blocking collaterals and the syndrome of phlegm and blood stasis.Logistics analysis showed that age≥50 years old,RF high titer positive,anti-CCP high titer positive,morning stiffness,fatigue,elevated leukocytes,decreased high-density lipoprotein,and elevated blood glucose were the risk factors for RA-ILD,and the use of TCM,TCM combined with western medicine were protective factors for RA-ILD.Conclusion Elderly RA patients with morning stiffness,fatigue,RF and anti-CCP high titer,increased leukocytes,reduced high-density lipoprotein,and elevated glucose should carry out regular pulmonary function tests as soon as possible so as to identify the risk of RA-ILD in early stage.At the same time,attention should be paid to the protective effects of traditional Chinese medicine and Western medicine in the occurrence and development of RA-ILD.

Rheumatoid arthritisInterstitial lung diseaseReal-world studyTCM cohortClinical featureSyndrome of stagnant dampness-heat

常甜、姜泉、姚传辉、刘子夏、马协丽、尚碧月、宋梦歌、张富渊、杨煜辰、巩勋

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中国中医科学院广安门医院,北京 100053

类风湿关节炎 间质性肺病 真实世界研究 中医队列 临床特征 湿热痹阻证

中央高水平中医医院临床科研业务费项目-中央高水平中医医院临床研究和成果转化能力提升项目中央高水平中医医院临床科研业务费项目-中央高水平中医医院临床研究和成果转化能力提升项目国家自然科学基金

HLCMHPP2023087HLCMHPP202301482230121

2024

中国中医基础医学杂志
中国中医研究院基础理论研究所

中国中医基础医学杂志

CSTPCD
影响因子：0.779
ISSN：1006-3250
年,卷(期)：2024.30(6)
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