河南漯河地区中老年人群类风湿关节炎危险因素及其患病情况分析

目的 了解贵州省黔南地区20～79岁农村居民类风湿关节炎患病现状及其危险因素，为采取相应干预措施提供参考依据。 方法 于2017年1月 — 2018年10月，采用整群随机抽样方法抽取黔南地区118 587名20～79岁农村居民进行问卷调查、常规检查、影像学检查和实验室检查，采用SAS 9.1软件进行统计学分析。 结果 贵州黔南地区居民类风湿关节炎患病1 097例，患病率为0.925 %，标化患病率为0.917 %。多因素非条件logistic回归分析结果显示，女性（OR = 5.512，95 % CI = 1.348～6.129）、年龄40～79岁、水族（OR = 4.812，95 % CI = 1.215～5.786）、毛南族（OR = 2.896，95 % CI = 1.223～4.195）、苗族（OR = 1.886，95 % CI = 1.136～3.603）、吸烟（OR = 3.108，95 % CI = 1.165～4.382）、口味偏重清淡（OR = 3.072，95 % CI = 1.207～4.506）、抑郁（OR = 2.798，95 % CI = 1.164～3.681）、居住环境潮湿（OR = 4.491，95 % CI = 1.275～5.765）、住在石板房（OR = 3.867，95 % CI = 1.218～5.963）、劳动强度Ⅲ级（OR = 2.817，95 % CI = 1.133～3.132）和Ⅳ级（OR = 3.927，95 % CI =1.226～4.929）、类风湿家族史（OR = 3.732，95 % CI = 1.137～5.214）、既往结核病史（OR = 2.084，95 % CI = 1.212～3.479）、既往腮腺炎史（OR = 2.014，95 % CI = 1.206～3.335）、外伤史（OR = 1.997，95 % CI = 1.136～3.421）、初潮年龄 ≥ 17岁（OR = 2.342，95 % CI = 1.215～4.667）是贵州黔南地区20～79岁农村居民类风湿关节炎患病的危险因素。布依族（OR = 0.397，95 % CI = 0.332～0.995）、其他民族（OR = 0.678，95 % CI = 0.462～0.997）、饮茶（OR = 0.487，95 % CI = 0.125 ～0.765）是贵州黔南地区20～79岁农村居民类风湿关节炎患病的保护因素。 结论 贵州黔南地区农村居民类风湿关节炎患病率较高，应针对该地区农村居民类风湿关节炎患病的危险因素进行干预。

Genetics of rheumatoid arthritis susceptibility,severity, and treatment response

Objective To examine the prevalence and risk factors of rheumatoid arthritis (RA) among rural residents aged of 20 – 79 years living in Qiannan prefecture of Guizhou province (Qiannan) and to provide references for developing relevant interventions. Methods We carried out a questionnaire survey, routine physical check up, imaging examination and laboratory tests among 118 587 residents aged 20 – 79 years selected with random cluster sampling in rural Qiannan between January 2017 and October 2018. We used SAS 9. 1 in data analyses. Results Among the participants, totally 1 097 RA cases were diagnosed; the crude and standardized RA prevalence rate was 0.925% and 0.917%. The results of multivariate unconditioned logistic regression revealed following risk factors of RA: female (odds ratio [OR] = 5.512, 95% confidence interval [95% CI]: 1.348 – 6.129), aged 40 – 79 years (compared to the aged 20 – 29 years: OR = 1.976 – 5.172), Shui nationality (OR = 4.812, 95% CI: 1.215 – 5.786), Maonan nationality (OR = 2.896, 95% CI: 1.223 – 4.195), Miao nationality (OR = 1.886, 95% CI: 1.136 – 3.603), smoking (OR = 3.108, 95% CI: 1.165 – 4.382), preference for light diet (OR = 3.072, 95% CI: 1.207 – 4.50), depression (OR = 2.798, 95% CI: 1.164 – 3.681), living in a damp environment (OR = 4.491, 95% CI: 1.275 – 5.765), living in a slate house (OR = 3.867, 95% CI: 1.218 – 5.963), engaged in a work with the labor intensity of grade Ⅲ (OR = 2.817, 95% CI: 1.133 – 3.132) or grade Ⅳ (OR = 3.927, 95% CI: 1.226 – 4.929), family RA history (OR = 3.732, 95% CI: 1.137 – 5.214), tuberculosis history (OR = 2.084, 95% CI: 1.212 – 3.479), mumps history (OR = 2.014, 95% CI: 1.206 – 3.335), injury history (OR = 1.997, 95% CI: 1.136 – 3.421), with a menarche age of ≥ 17 years old (OR = 2.342, 95% CI: 1.215 – 4.667); the results also indicated following protective factors against RA: Buyi nationality (OR = 0.397, 95% CI: 0.332 – 0.995), other nationality (OR = 0.678, 95% CI: 0.462 – 0.997), and tea drinking (OR = 0.487, 95% CI: 0.125 – 0.765). Conclusion The prevalence rate of rheumatoid arthritis is relatively high and interventions on risk factors of the disease needs to be conducted among 20 – 79 years old residents in rural regions of Qiannan prefecture of Guizhou province.