类风湿性关节炎合并原发性高血压的危险因素分析

目的 探讨类风湿性关节炎（RA）患者合并原发性高血压的相关危险因素。方法 回顾性分析 2016 年 6 月至 2019年 11 月安徽医科大学第一附属医院风湿免疫科收治的 711 例 RA 患者临床资料，根据是否合并原发性高血压分为观察组（n=125）和对照组（n=586），比较两组一般资料、疾病相关指标及药物使用情况差异。利用趋势 χ²检验比较不同年龄、病程和身体质量指数（BMI）的 RA 患者原发性高血压的患病率，并采用二分类 logistic 回归分析 RA 患者合并原发性高血压的危险因素。结果 两组在年龄、BMI、病程、合并 2 型糖尿病（T2DM）和使用糖皮质激素（GC）、羟氯喹（HCQ）方面比较，差异均有统计学意义（P 均＜0.05），而在疾病活动度评分（DAS28），使用甲氨蝶呤（MTX）、来氟米特（LEF）以及常规抗风湿药（cDMARDs）方面比较，差异均无统计学意义（P 均＞0.05）。logistic 回归显示，年龄大（OR=1.056，95%CI：1.034~1.077，P<0.001）、BMI 高（OR=1.120，95%CI：1.060~1.184，P<0.001）、合并T2DM（OR=3.012，95%CI：1.664~5.435，P<0.001）以及使用 GC（OR=1.996，95%CI：1.238~3.215，P=0.005）是 RA 患者合并原发性高血压的危险因素，而使用 HCQ（OR=0.604，95%CI：0.389~0.937，P=0.024）为其保护因素。结论 年龄、BMI 增长以及 GC 使用可致 RA 患者原发性高血压患病率升高，而使用 HCQ 可降低此类患者患病风险。

Analysis of risk factors for rheumatoid arthritis associated with essential hypertension

Objective To investigate the risk factors for rheumatoid arthritis associated with essential hypertension in patients. Methods A retrospective analysis was performed to compare the clinical data of 711 rheumatoid arthritis patients admitted to the Rheumatology and Immunology Department of the First Affiliated Hospital of Anhui Medical University from June 2016 to November 2019.According to the presence or absence of essential hypertension, they were divided into the observation group (n=125) and the control group (n=586), and the differences in general data, disease-related indicators and drug use between the two groups were compared.The trend χ² test was used to compare the prevalence of essential hypertensionamong rheumatoid arthritis patients with different ages, different disease duration, and different body mass index.Binary logistic regression analysis was used to analyze the risk factors of essential hypertension in rheumatoid arthritis patients. Results There were significant differences in age, body mass index, course of disease, comorbid type 2 diabetes mellitus, and use of glucocorticoids and hydroxychloroquine between the two groups. There were no statistically significant levels in disease activity score in 28 joints、methotrexate、leflunomide and conventional disease modifying antirheumatic drugs use. The results of logistic regression analysis showed:older age (OR=1.056，95%CI：1.034~1.077，P<0.001),high body mass index(OR=1.120，95%CI：1.060~1.184，P<0.001), concomitant with type 2 diabetes mellitus (OR=3.012，95%CI：1.664~5.435，P<0.001), the use of glucocorticoid (OR=1.996，95%CI：1.238~3.215，P=0.005) were found to be risk factors for rheumatoid arthritis in the comorbid of essential hypertension.The use of hydroxychloroquine (OR=0.604，95%CI：0.389~ 0.937，P=0.024)was a protective factor for essential hypertension in patients with rheumatoid arthritis. Conclusions The prevalence of essential hypertension in RA patients increases with age, body mass index and glucocorticoid use.The use of hydroxychloroquine may reduce the risk of these patients.