| 文建庭,刘健,万磊,忻凌,董文哲,方妍妍.骨关节炎1904例终点事件发生情况队列研究[J].中国临床保健杂志,2018,21(4):456-461. |
| 骨关节炎1904例终点事件发生情况队列研究 |
| Cohort study on the endpoint events in 1904 patients with osteoarthritis |
| 投稿时间：2018-03-19 |
| DOI：10.3969/J.issn.1672-6790.2018.04.006 |
| 中文关键词: 骨关节炎 队列研究 中草药 危险因素 |
| 英文关键词: Osteoarthritis Cohort studies Drugs,Chinese herbal Risk factors 〖FL |
| 基金项目:安徽省科技攻关项目(1604a0802085)；中医药行业科研专项(201307001)；2016年中央引导地方科技发展专项(财教〔2016〕1188)；现代中医内科应用基础与开发研究安徽省重点实验室(财教〔2016〕518)；2015年技术创新服务体系专项(财教〔2015〕1551) |
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| 中文摘要: |
| 目的 随访安徽省中医院骨关节炎(OA)出院患者终点事件发生情况,探讨其终点事件发生的相关因素。方法 纳入安徽省中医院2012年1月至2016年6月期间首次诊断为骨关节炎患者的病例,调取并记录骨关节炎患者的一般资料,采用电话随访方式,随访并记录出院患者中医药使用情况(按照出院后服药时间的长短分为非暴露组、低暴露组、中暴露组和高暴露组),终点事件发生情况,包括事件种类(全因死亡、关节外病变、再发入院和手术治疗)、发生时间、次数及依据,随后调取并记录随访成功骨关节炎患者首次入院的实验室指标,包括炎性指标、免疫指标、代谢指标,并采用多元logistic回归分析法分析中医药治疗、年龄、性别、常规西药治疗、实验室指标等与骨关节炎患者终点事件发生的相关性。结果 共纳入1904例骨关节炎患者,随访成功1658例,失访的有246例,失访率12.92%。随访期间发生的终点事件有99例,包括全因死亡15例(15.15%)、关节外病变13例(13.13%)、再发入院46例(46.46%)和手术治疗25例(25.25%)。由多元logistic回归分析法分析得出骨关节炎患者终点事件与各因素之间的相关性,结果表明,全因死亡的相关因素是中医药暴露强度(OR=0.319)、再发入院的相关因素是中医药暴露强度(OR=0.469)、关节外病变的相关因素是中医药暴露强度(OR＝0.522)、手术治疗的相关因素是中医药暴露强度(OR＝0.507),年龄(OR=0.976)、红细胞沉降率(ESR)(OR=1.604)、血小板计数(PLT)(OR=2.667)、免疫球蛋白G(IgG)(OR=1.404)、α1-酸性糖蛋白(α1-AGP)(OR＝2.291)能够增加患者再发入院的发生率,年龄(OR＝0.750)能够增加OA患者关节外病变的风险,超敏C反应蛋白(OR=1.621)能够增加OA患者手术的风险。结论 足疗程的中医药治疗能减少骨关节炎终点事件的发生。 |
| 英文摘要: |
| Objective Cohort study was conducted to follow up the occurrence dynamics of endpoint events of Osteoarthritis(OA)patient who were diagnosed in tradtional Chinese medicine hospital of Anhui province,and investigate the related factors of the occurrence of endpoint events.Methods Hospitalized cases with first diagnosis of acute osteoarthritis from January 2012 to June 2016 in traditional Chinese medicine hospital of Anhui province were collected,and the general information of patients with acute osteoarthritis were taken and recorded.By using the telephone follow-up,followed up and the usage of traditional Chinese medicine (TCM),and the occurrence dynamics of endpoint events were recorded,including its types,time,frequency and the evidence.Then,laboratory index of the patients with osteoarthritis who were followed up successfully,including inflammatory index,immune index,metabolic index and rheumatic index.Logistic regression analysis was used to analyze the correlation of TCM intervention intensity,age,gender,complications,drug usage,western medicine,laboratory index and other indicators related to the occurrence of endpoint events.Results1904 patients with RA were included totally and 1658 patients had complete follow-ups,while 246 patients were lost to follow-up,which rated 12.92%.During follow-ups,the frequencies of the endpoint was 99,including recurrent admission (46.46%),extra articular lesions (13.13%),all-cause death (15.15%),and surgical treatment (25.25%).The multivariate logistic regression analysis showed that there was a correlation between endpoint events and various factors in patients with osteoarthritis.The results showed that TCM intervention Intensity (OR=0.319) was a related factor of all-cause death,that TCM intervention Intensity (OR=0.469) was a related factor of recurrent admission,that TCM intervention Intensity (OR＝ 0.522) was a related factor of extra articular lesions,that TCM intervention Intensity (OR＝0.507) was a related factor of surgical treatment,that Age (OR=0.976),ESR(OR=1.604),PLT(OR=2.667),IgG(OR=1.404),α1-AGP(OR＝2.291) can increase the incidence of recurrent hospital admissions,that Age (OR=0.750) can increase the risk of extra articular disease of OA patients and that hs-CRP(OR=1.621) can increase the risk of surgery in patients of OA.Conclusion TCM intervention intensity is related to the occurrence of each endpoint events of osteoarthritis,and enough intensity of intervention could decrease the incidence rate of endpoint events of osteoarthritis. |
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