摘要
目的分析痛风合并骨侵蚀患者的临床特点及危险因素。方法回顾性分析2022年1月至2023年2月在青岛大学附属烟台毓璜顶医院风湿免疫科诊治的590例痛风患者的临床资料。根据超声检查结果分为骨侵蚀组(223例)和非骨侵蚀组(367例)。分析痛风合并骨侵蚀患者的临床特点。采用多因素logistic回归分析痛风合并骨侵蚀的危险因素,通过受试者工作特征(ROC)曲线分析研究各指标对痛风合并骨侵蚀的预测效能。结果590例痛风患者中有223例(37.80%)合并骨侵蚀,其中以累及第一跖趾关节最为多发(74.44%),且以单关节受累为主(65.92%)。多因素logistic回归分析结果显示,病程长、发作频率高以及较高的胱抑素C(CysC)水平是促进痛风合并骨侵蚀发生的独立危险因素(P<0.05)。ROC曲线分析结果显示,病程、发作次数及CysC水平均能有效预测痛风合并骨侵蚀发生(P<0.05),三项指标联合可进一步提高预测效能[AUC(95%CI)=0.933(0.911~0.955),P<0.001],灵敏度和特异度分别达87.00%、87.74%。结论痛风合并骨侵蚀患者以第一跖趾关节受累为主。针对病程延长、发作频繁、CysC水平升高的患者应予以积极干预,阻止疾病进展。
Objective To analyze the clinical characteristics and risk factors of the gout patients complicated with bone erosion.Methods The clinical data of 590 gout patients who were diagnosed and treated in the Department of Rheumatology and Immunology of the Affiliated Yantai Yuhuangding Hospital of Qingdao University from January 2022 to February 2023 were retrospectively analyzed.According to the results of ultrasonography,the patients were divided into bone erosion group(223 cases)and non-bone erosion group(367 cases).The clinical characteristics of the gout patients complicated with bone erosion were analyzed.Multivariate logistic regression was used to analyze the risk factors of the gout patients complicated with bone erosion,and the predictive efficacy of the studying indicators in the gout patients complicated with bone erosion was analyzed using receiver operating characteristic(ROC)curve.Results Among the 590 gout patients,223 cases(37.80%)were complicated with bone erosion,with the first metatarsophalangeal joint being the most common predilection site(74.44%),and the single joint was the most involved site(65.92%).The results of multivariate logistic regression analysis showed that long course of the disease,high frequency of attack and high level of cystatin C(CysC)were the independent risk factors for promoting the occurrence of gout complicated with bone erosion(P<0.05).The results of ROC curve analysis showed that disease duration,attack frequency and CysC level could effectively predict the occurrence of gout complicated with bone erosion(P<0.05),and the combination of these three indicators could further improve the prediction efficiency[AUC(95%CI)=0.933(0.911-0.955),P<0.001],and the sensitivity and specificity were 87.00%and 87.74%,respectively.Conclusion The first metatarsophalangeal joint is the mainly involved site in the gout patients complicated with bone erosion.For the patients with prolonged disease course,frequent attacks and increased CysC level,active intervention should be given to prevent disease progression.
作者
张福云
赵娜
汤艳春
ZHANG Fu-yun;ZHAO Na;TANG Yan-chun(Department of Rheumatology and Immunology,the Affiliated Yantai Yuhuangding Hospital of Qingdao University,Shandong 264000,China)
出处
《中国临床新医学》
2023年第11期1180-1184,共5页
CHINESE JOURNAL OF NEW CLINICAL MEDICINE
关键词
痛风
骨侵蚀
临床特点
危险因素
Gout
Bone erosion
Clinical characteristics
Risk factor
作者简介
张福云,在读硕士研究生,研究方向:痛风及其并发症的诊治。E-mail:fuyunz08@163.com;通信作者:汤艳春,医学硕士,主任医师,硕士研究生导师,研究方向:痛风及其并发症的诊治。E-mail:yt.lyls@163.com。
