【作者】
刘娜；
王晓元；
王秀茹；
穆荣；
李春；
安媛；
周云杉；
李晓峰；
王莉枝；
王彩虹；
王永福；
杨荣；
王国春；
卢昕；
朱平；
陈丽娜；
刘金婷；
靳洪涛；
刘湘源；
孙琳；
魏平；
王俊洋；
陈海英；
崔刘福；
舒荣；
刘白鹭；
张卓莉；
李光韬；
李振彬；
杨静；
李俊芳；
贾彬；
张风肖；
陶杰梅；
韩淑玲；
林金盈；
韦美秋；
刘晓敏；
柯丹；
胡绍先；
叶丛；
杨岫岩；
李昊；
黄慈波；
高明；
赖蓓；
李兴福；
宋立军；
王轶；
苏茵；
栗占国；
【Author】
Liu Na;Wang Xiaoyuan;Wang Xiuru;Mu Rong;Li Chun;An Yuan;Zhou Yunshan;Li Xiaofeng;Wang Lizhi;Wang Caihong;Wang Yongfu;Yang Rong;Wang Guochun;Lu Xin;Zhu Ping;Chen Lina;Liu Jinting;Jin Hongtao;Liu Xiangyuan;Sun Lin;Wei Ping;Wang Junyang;Chen Haiying;Cui Liufu;Shu Rong;Liu Bailu;Zhang Zhuoli;Li Guangtao;Li Zhenbin;Yang Jing;Li Junfang;Jia Bin;Zhang Fengxiao;Tao Jiemei;Han Shuling;Lin Jinying;Wei Meiqiu;Liu Xiaomin;Ke Dan;Hu Shaoxian;Ye Cong;Yang Xiuyan;Li Hao;Huang Cibo;Gao Ming;Lai Bei;Li Xingfu;Song Lijun;Wang Yi;Su Yin;Li Zhanguo;Department of Rheumatology and Immunology,Peking University People’s Hospital,Beijing Key Laboratory of Rheumatism Mechanism and Immune Diagnosis(BZ0135);Department of Rheumatology and Immunology,Lanzhou University Second Hospital;Department of Rheumatology and Immunology,Peking University Shougang Hospital;Department of Rheumatology and Immunology,the Second Hospital of Shanxi Medical University;Department of Rheumatology and Immunology,the First Hospital of Baotou Medical Collage;Department of Rheumatology and Immunology,China-Japan Friendship Hospital;Department of Rheumatology and Immunology,the Fourth Military Medical University Xijing Hospital;Department of Rheumatology and Immunology,the Second Hospital of Hebei Medical University;Department of Rheumatology and Immunology,Peking University Third Hospital;Department of Rheumatology and Immunology,the Third Hospital of Hebei Medical University;Department of Rheumatology and Immunology,Kailuan Hospital of North China Coal Medical College;Department of Rheumatology and Immunology,Peking University First Hostpital;Department of Rheumatology and Immunology,Bethune International Peace Hospital;Department of Rheumatology and Immunology,Handan Central Hospital,Hebei Province;Department of Rheumatology and Immunology,Hebei People’s Hospital;Department of Rheumatology and Immunology,the People’s Hospital of Guangxi Zhuang Autonomous Region;Department of Rheumatology and Immunology,the Hospital of Shunyi District Beijing;Department of Rheumatology and Immunology,Tongji Hospital of Tongji Medical College of Huazhong University of Science and Technology;Department of Rheumatology and Immunology,the First Affiliated Hospital,Sun Yat-sen University;Department of Rheumatology and Immunology,Beijing Hospital;Department of Rheumatology and Immunology,Qilu Hospital of Shandong University;
【机构】
北京大学人民医院风湿免疫科风湿病机制及免疫诊断北京市重点实验室(BZ0135)；
兰州大学第二医院风湿免疫科；
北京大学首钢医院风湿免疫科；
山西医科大学第二附属医院风湿免疫科；
包头医学院第一附属医院风湿免疫科；
中日友好医院风湿免疫科；
第四军医大学西京医院风湿免疫科；
河北医科大学第二附属医院风湿免疫科；
北京大学第三医院风湿免疫科；
河北医科大学第三医院风湿免疫科；
华北煤炭医学院附属开滦医院风湿免疫科；
北京大学第一医院风湿免疫科；
白求恩国际和平医院风湿免疫科；
河北省邯郸市中心医院风湿免疫科；
河北省人民医院风湿免疫科；
广西壮族自治区人民医院风湿免疫科；
北京市顺义区医院风湿免疫科；
华中科技大学同济医学院附属同济医院风湿免疫科；
中山医科大学第一附属医院风湿免疫科；
北京医院风湿免疫科；
山东大学齐鲁医院风湿免疫科；
【摘要】 目的 调查糖皮质激素在我国类风湿关节炎(RA)患者治疗中的应用现况。方法 采用回顾性方法调查分析2009年1月至2010年8月在全国21家医院风湿科门诊或住院治疗的1 095例RA患者的一般资料、临床和实验室资料及糖皮质激素用药情况。结果 1 095例RA患者中,曾使用糖皮质激素治疗者417例,占38.1%。359例RA患者可查到激素详细用量。其中,小剂量激素(≤10 mg/d泼尼松等效剂量)治疗者219例,占61.0%;中等剂量激素(>10 mg/d且≤30 mg/d泼尼松等效剂量)治疗者119例,占33.1%;较大剂量激素(>30 mg/d泼尼松等效剂量)治疗者21例,占5.9%。有明确记录激素用药时长的353例RA患者中,107例患者(30.3%)总激素应用时长≤6个月,246例(69.7%)>6个月。将所有患者根据是否使用糖皮质激素分为用激素组(417例)与未用激素组(678例)。用激素组患者总体病程、确诊时病程、畸形关节数、关节外症状所占比例以及健康评定调查量表评分均明显高于未用激素组[87.6(32.4,176.4)个月比58.2(17.7,139.2)个月、4.1(0.0,27.4)个月比2.0(0.0,12.9)个月、2(0,6)个比1(0,4)个、31.2%(130/417)比20.4%(138/678)、0.8(0.1,1.6)分比0.5(0.0,1.4)分],差异均有统计学意义(P<0.05)。但2组患者应用改善病情抗风湿药物、生物制剂及非甾体消炎药的比例差异均无统计学意义(均P>0.05)。结论 糖皮质激素仍是我国目前治疗重症RA的常用药物,但国内对于糖皮质激素在RA治疗中的应用尚需进一步规范。更多还原
【Abstract】 Objective To investigate the application of glucocorticoids in patients with rheumatoid arthritis(RA) in China.Methods Totally 1 095 cases of RA from 21 hospitals in China from January 2009 to August2010 were retrospectively enrolled.Clinical data,laboratory data and application of glucocorticoids were analyzed.Results In 1 095 patients with RA,417 patients(38.1%)were treated with glucocorticoids,detailed dosages of glucocorticoid were available in 359 cases of them.In these 359 cases,219 cases(61.0%) were treated with lowdose glucocorticoid(≤10 mg/d prednisone equivalent dose),119 cases(33.1%) were treated with medium-dose glucocorticoid(> 10 mg/d and ≤30mg/d prednisone equivalent dose) and 21 cases(5.9%) were treated with high-dose glucocorticoid(>30mg/d prednisone equivalent dose);107 cases(30.3%) had treatments shorter than6 months and 246 cases(69.7%) were treated longer than 6 months.All patients were divided into glucocorticoid group(417 cases) and non-glucocorticoid group(678 cases).The total course of RA,the course of diagnosis,the number of abnormal joints,the proportion of extra articular symptoms and the health assessment questionaire(HAQ)score in glucocorticoid group were all significantly higher than those in non-glucocorticoid group[87.6(32.4,176.4) months vs 58.2(17.7,139.2) months;4.1(0.0,27.4) months vs 2.0(0.0,12.9) months;2(0,6) vs 1(0,4);31.2%(130/417) vs 20.4%(138/678);0.8(0.1,1.6)scores vs 0.5(0,1.4)scores](all P<0.05).Proportions of antirheumatic drug,biologies and non-steroidal anti-inflammatory drug applications had no significant differences between groups(P > 0.05).Conclusion At present,glucocorticoids is wildly used in severe RA patients in China,but the application needs to be standardized.更多还原
【基金】 国家自然科学基金(81471536);国家重点基础研究发展计划(973项目)(2012CB517702)~~
