风湿性关节炎患者因特定原因死亡率的差异根据性别和血清阳性
Elena K Joerns1, Andrea Lopez-Ruiz2, Ryan J Lennon3
1E.K. Joerns, MD, MPH, Division of Rheumatology, Department of Internal Medicine, Mayo Clinic, Rochester, Minnesota.
The Journal of rheumatology
|September 15, 2025
概括
类风湿性关节炎 (RA) 患者,特别是血清阳性患者,面临死亡率增加,特别是由于呼吸道原因. 血清阴性RA患者没有表现出这种高风险.
科学领域:
- 类风湿病学 类风湿病学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 类风湿性关节炎 (RA) 是一种慢性自身免疫性疾病,影响关节和潜在的其他器官.
- 了解RA的死亡率趋势和风险因素对于患者管理和公共卫生战略至关重要.
研究的目的:
- 检查与预期率相比,RA患者的全因死亡率趋势.
- 调查RA血清状况和性别对所有原因和特定原因死亡率的影响.
主要方法:
- 一项针对RA患者的回顾性队列研究,与来自俄尔姆斯特德县的非RA对照进行了匹配,MN (1980-2019).
- 分析包括竞争风险/累积发病率方法和考克斯模型来评估死亡风险.
- 研究了RA,性别,年龄,血清阳性和日历年之间的相互作用.
主要成果:
- 在RA患者中,特别是血清阳性个体中,全因死亡率较高,在20世纪80年代之后观察到下降.
- 在血清阳性RA患者 (aHR 2.26) 与血清阴性RA患者 (aHR 0.52) 相比,呼吸道死亡风险显著增加.
- 在因特定原因的死亡率中没有发现基于性别的显著差异.
结论:
- 在RA中,血清阳性是增加死亡率的重要危险因素,特别是由于呼吸道原因.
- 在这种队列中,血清阴性RA患者的死亡风险没有增加.
- 这些发现强调了血清状况在预测类风湿性关节炎死亡结果方面的重要性.
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