老年类风湿关节炎患者发生骨质疏松的危险因素分析

目的调查老年类风湿关节炎(RA)患者骨质疏松(OP)的发生情况并分析其危险因素,为有效预防和干预提供依据。方法选取2012年1月至2017年9月我院收治的老年RA患者684例,根据其发生OP的情况分为OP组(383例)和非OP组(301例),记录患者一般资料及OP的相关因素。应用二分类非条件Logistic回归分析老年RA患者发生OP的危险因素。结果在684例老年RA患者中383例发生OP,发生率高达56.0%。随着年龄的增长,男、女性骨质疏松症患病率均明显增加,差异有统计学意义(P0.05)。OP组的腰椎(-2.98±0.94 vs-0.85±0.62)、股骨颈(-2.53±0.76 vs-0.82±0.57)、全髋(-1.95±0.81 vs-0.29±0.24)骨密度T值均明显低于非OP组(P0.05)。二分类非条件Logistic回归分析显示,年龄OR=1.805(95%CI:1.613~2.274)]、病程OR=1.603(95%CI:1.431~1.968)]、ESROR=1.583(95%CI:1.286~1.815)]、DAS28评分OR=1.729(95%CI:1.504~2.063)]是老年RA患者发生OP的独立危险因素,而BMIOR=0.752(95%CI:0.674~0.926)]、摄入钙OR=0.584(95%CI:0.318~0.720)]、ALBOR=0.803(95%CI:0.725~0.993)]、25(OH)DOR=0.713(95%CI:0.620~0.857)]可能是OP保护因素。结论老年RA患者OP的发生率较高,影响其发生的危险因素较多,应做到早预防、早发现,以减少或延缓OP的发生。

Analysis of the risk factors of osteoporosis in elderly patients with rheumatoid arthritis

Objective To investigate the incidence and risk factors of osteoporosis (OP) in elderly patients with rheumatoid arthritis (RA), so as to provide evidence for effective prevention and intervention. Methods Six hundred and eighty-four cases of elderly RA patients in our hospital from January 2012 to September 2017 were divided into OP group (383 cases) and non-OP group (301 cases) based on the occurrence of OP. The general data and related factors of OP were recorded. The risk factors of OP in elderly RA patients were analyzed with two-classification non-conditional logistic regression. Results In 684 elderly patients with RA, 383 had OP, and the incidence was up to 56%. The incidence of OP in men and women increased with age, and the difference was statistically significant (P<0.05). The bone mineral density (T) of the lumbar spine (-2.98±0.94 vs -0.85±0.62), the femoral neck (-2.53±0.76 vs -0.82±0.57), and the total hip (-1.95±0.81 vs -0.29±0.24) in the OP group was significantly lower than that in the non-OP group (P<0.05). Two classification and unconditional logistic regression analysis showed that age OR=1.805 (95%CI: 1.613-2.274)], course of disease OR=1.603 (95%CI: 1.431-1.968)], ESR OR=1.583 (95%CI: 1.286-1.815)], and DAS28 OR=1.729 (95%CI: 1.504-2.063)] score were independent risk factors for OP in elderly RA patients, while BMI OR=0.752 (95%CI: 0.674-0.926)], calcium intake OR=0.584 (95%CI: 0.318-0.720)], ALB OR=0.803 (95%CI: 0.725-0.993)], and 25 (OH) D OR=0.713 (95%CI: 0.620-0.857)] might be OP protection factors. Conclusion The incidence of OP in elderly patients with RA is high, and there are many risk factors affecting it. Early prevention and detection should be done to reduce or delay the occurrence of OP.