| Objective To explore the clinical characteristics and immunological indexes of rheumatoid arthritis patients at different ages of onset,and to provide some reference for clinical daily diagnosis and treatment.Methods Approximately 3915 patients who were diagnosed as rheumatoid arthritis in Ning Xia University General from January 2013 to June 2018 were selected.A total of 459 subjects were selected by isometric sampling according to inclusion and exclusion criteria.The selected inpatients were grouped by the age of onset:the young age group:age of onset<45years old,the middle age group:45 years old?age of onset<60 years old;the elderly age group:age of onset?60 years old.Collect general data,comorbidities,first affected joints,general laboratory test data,immunological indicators,inflammatory indicators,imaging examinations and other clinical data of the three groups of patients,and the results were evaluated using statistical methods.Results1.General codition:(1)Among 459 RA patients,219 were in the young group,185 were in the middle-aged group,and 55 were in the elderly group,with the highest frequency of onset age being 45-60 years[174 cases(37.9%)];(2)In terms of the sex composition ratio of men and women,there were differences in the young,middle-aged,and elderly groups,respectively:1:5.6,1:3.1,1:2.9(P<0.001),women are all higher than men;(3)The average level of BMI is highest in the youth group,middle in the middle-aged group,and lowest in the elderly groupt[young age group(22.69±2.79kg/m~2[middle age group(22.32±2.40kg/m~2),the elderlyage group(21.29±1.74 kg/m~2),P<0.05].2.Complications:(1)The proportion of middle-aged group and elderly group with hypertension is higher than that of young group[70 cases(32.0%)in young group,82 cases(44.3%)in middle-age group,30 cases(54.5%)in elderly group,P<0.05];(2)The proportion of coronary heart disease in the middle-aged group and the elderly is higher than that in the young group[49 cases(22.4%)in the young group,72 cases(38.9%)in the middle-age group,33 cases(40.3%)in the elderly group,P<0.05];The proportion of elderly patients with osteoarthritis was higher than that of the young group and the middle-age group[58 cases(26.5%)in the young group,48cases(25.9%)in the middle-age group,and 24cases(43.6%)in the elderly group,P<0.05].3.Primary affected joints:(1)The proportion of patients with primary affected joints in the proximal interphalangeal and metacarpophalangeal joints was higher in the young and middle-aged groups than in the elderly[71 cases in the youth group(49.3%),68 cases in the middle-aged group(47.2%),5 cases in the elderly group(3.5%);70 cases in the youth group(60.9%),43 cases in the middle-aged group(50.6%),32 cases in the elderly group(22.1%),P<0.001];(2)The proportion of young patients with first-time involvement of the wrist was higher than that of middle-aged and elderly patients[15 cases in the youth group(65.2%),3cases in the middle age group(13.0%),5 cases in the old group(21.7%),P<0.001].4.General laboratory test data:The median WBC level in the elderly group is higher than that in the middle-aged group and the youth group[6.20(4.81,7.76)×10~9/L in the young age group,6.35(5.05,7.725)×10~9/L in the middle age group,7.17(6.13,8.11)×10~9/L in the elderly age group,P<0.05].5.Inflammatory indicators:The median level of CRP in the elderly group is higher than that in the young and middle-aged groups[youth group 3.9(2.97,36.5mg/L),middle-aged group 18.1(4.18,39.85mg/L),and elderly group 24.1(9.98,43.7),P<0.05].6.Immunological indicators:The positive rate of anti-CCP antibodies in the young group was higher than that in the middle-aged group and the elderly group[124 cases(56.6%)in the young group,98 cases(53.0%)in the middle-age group,and 18 cases(32.7%)in the elderly group,P<0.05].7.Imaging performance:The proportion of elderly patients with pulmonary interstitial lesions is higher than that of the young and middle-aged groups[65(35.33%)in the young group,41(34.17%)in the middle-age group,22(62.86%)in the elderly group,P<0.05].Conclusion1.RA is more common in women aged 45-60 years.With the increase of age,the incidence of males gradually increases.2.The first joints of RA patients in the young group were the metacarpophalangeal joints,proximal interphalangeal joints,and wrist joints;the BMI of the young group RA patients was higher than that of the elderly group.3.The middle joints of RA patients were the metacarpophalangeal joints and proximal interphalangeal joints;the proportion of middle-aged and elderly patients with hypertension and coronary heart disease was higher than that of the young group.4.The CRP,osteoarthritis,and pulmonary interstitial lesions of RA patients in the elderly group were higher than those in the middle-aged group and the young group. |
PDF Full Text Request