类风湿性关节炎患者高脂血症发病率及相关因素分析

Incidence rate and related factors of hyperlipidemia in patients with rheumatoid arthritis

摘要:

目的 分析类风湿性关节炎（RA）患者高脂血症发病率及相关因素。方法 选取158例2021年8月至2023年5月期间在平顶山市中医院就诊的类风湿关节炎患者，按照总胆固醇水平分为高脂血症组（n=90）和对照组（n=68）。比较两组C反应蛋白（CRP）、类风湿因子、抗环瓜氨酸肽（CCP）抗体和血脂水平。使用Logistic分析研究类风湿关节炎高脂血症的相关因素，使用皮尔逊相关分析评估总胆固醇与CRP和疾病活动度的的关系。结果 高脂血症在类风湿人群中的患病率为56.96%。高脂血症组的高甘油三酯（TG）、低高密度脂蛋白（HDL）和高低密度脂蛋白（LDL）比例显著高于对照组（P<0.05）。多因素Logistic回归分析发现CRP（调整后O^R=1.78, 95%CI: 1.29~4.11, P<0.001）、抗CCP（调整后O^R=0.86, 95%CI: 0.69~0.97, P<0.001）、TG（调整后O^R=1.39, 95%CI: 1.14~2.07, P<0.001）、LDL（调整后O^R=1.81, 95%CI: 1.21~3.39, P<0.001）为类风湿患者高脂血症的相关因素。相关分析结果显示CRP水平的28-关节疾病活动度评分指数与总胆固醇水平之间存在统计学意义上的显著正相关（r=0.25，P=0.016）。结论 高脂血症在RA患者中很常见，并且与CRP水平和疾病活动度密切相关，有必要提高医护人员对RA活动期高脂血症的认识。

Abstract:

Objective To analyze the incidence rate and related factors of hyperlipidemia in patients with rheumatoid arthritis.Methods Totally 158 patients with rheumatoid arthritis treated in Pingdingshan Traditional Chinese Medicine Hospital from August 2021 to May 2023 were selected and divided into a hyperlipidemic group (n=90) and a control group (n=68) based on total cholesterol levels. The levels of C-reactive protein, rheumatoid factor, anti CCP antibody, and blood lipids between the two groups were compared. Logistic analysis was used to study the related factors of hyperlipidemia in rheumatoid arthritis, and Pearson correlation analysis was used to evaluate the relationship between total cholesterol, CRP, and disease activity.Results The incidence of hyperlipidemia in the rheumatoid population was 56.96%. The proportion of high TG, low HDL, and high LDL in the hyperlipidemia group was significantly higher than that in the control group, and the difference was statistically significant (P<0.05). Multivariate logistic regression analysis found that CRP (adjusted O^R=1.78, 95% CI 1.29–4.11, P<0.001), anti CCP (adjusted O^R=0.86, 95% CI 0.69–0.97, P<0.001), TG (adjusted O^R=1.39, 95% CI 1.14–2.07, P<0.001), and LDL (adjusted O^R=1.81, 95% CI 1.21–3.39, P<0.001) were related factors for hyperlipidemia in patients with rheumatoid arthritis. The correlation analysis results showed a statistically significant positive correlation between the 28 joint disease activity score index of CRP level and total cholesterol level (r=0.25, P=0.016).Conclusion Hyperlipidemia is common in rheumatoid arthritis patients and is closely related to CRP levels and disease activity. It is necessary to improve the understanding of medical staff about active hyperlipidemia in rheumatoid arthritis.