摘要
目的通过对比分析RA合并2型糖尿病患者的临床资料，探讨这类患者代谢方面的特点，为心血管危险因素的管理提供更多的理论依据。方法将104例RA合并2型糖尿病患者作为研究对象，另选择年龄、性别相匹配的100名健康体检者作为对照组。对比2组代谢指标并总结分析研究组代谢异常的比例。统计学方法采用t检验和x2检验。结果RA与2型糖尿病的平均病程分别为（8±6）年、（10±5）年；55．8％（58／104）的患者CRP〉10mg／L，72．1％（75／104）的患者ESR〉30mm／1h；RF阳性率为76％。RA组BMI（23．3±3．1）kg／m2，对照组（23．4±2．8）kg／m2，2组BMI差异无统计学意义（P=0．991）；RA合并2型糖尿病组的收缩压、舒张压均显著高于对照组（P〈0．01）；RA组血尿酸（0．27±0．11）mmol／L，对照组（0．27±0．12）mmol／L，2组血尿酸差异无统计学意义（P=0．957）；脂代谢方面，除2组TC差异无统计学意义外[RA组（4．6±1．0）mmol／L，对照组（4．5±0．5）mmol／L，P=0．547]，TG[RA组（1．4±0．8）mmol／L，对照组（1．1±0．3）mmol／L]、HDL—C[RA组（1．1±0．3）mmol／L，对照组（1．5±0．4）mmol／L]、LDL-C[RA组（2．6±0．8）mmol／L，对照组（2．4±0．4）mmol/L]，差异均有统计学意义（t=2．871，P=0．005；t=-7．064，P〈0．01；t=2．003，P=0．047）。高血压比例为36．5％（38／104），糖化血红蛋白（HbA1C）≥7％的比例为45．1％（14／31）；TC升高的比例为17．3％（18／104），TG升高的比例为30．7％（32／104），HDL-C降低比例为26．9％（28／104），LDL-C升高的比例为27．8％（29／104）。结论高血压发生率较高，血糖控制欠佳，高发的脂代谢紊乱是RA合并2型糖尿病患者的突出代谢特点。临床医生特别是风湿科医生需要对上述几个方面给予足够的重视。
Objective To explore the metabolic characteristics of rheumatoid arthritis (RA) patients with type 2 diabetes (T2DM) and provide evidence for the management of cardiovascular risk factors. Methods One hundred and four RA patients with T2DM and 100 healthy subjects with matched age and sex were the subjects of study. The metabolic parameters of the two groups was compared and the ratio of metabolic abnormalities in RA with T2DM group was analyzed. Comparisons between groups were analyzed by t-test and Chi-square analysis. Results The average duration of RA and T2DM were (8±6) and (10±5) years respectively; 55.8% patients with CRP>10 mg/L and 72.1% patients with ESR>30 mm/1 h. There was no significant difference in body mass index between the two groups [(23.3 ±3.1) kg/m2 vs (23.4 ±2.8) kg/m2, P=0.991]. The systolic blood and diastolic blood pressures of RA patients with T2DM were significantly higher than those of the control group (P<0.01). There was no significant difference in blood uric acid [(0.27 ± 0.11) mmol/L vs (0.27 ±0.12) mmol/L, P=0.957]. There was no significant difference in the levels of total cholesterol (TC) [(4.6 ±1.0) mmol/L vs (4.5 ±0.5) mmol/L, P=0.547], but the levels of triglyceride (TG), high density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) [TG (1.4±0.8) mmol/L vs (1.1 ±0.3) mmol/L, t=2.871, P=0.005; HDL-C (1.1 ±0.3) mmol/L vs (1.5 ±0.4) mmol/L, t=-7.064, P<0.01;LDL-C (2.6±0.8) mmol/L vs (2.4±0.4) mmol/L, t=2.003, P=0.047] were significantly different in the two groups. 36.5% patients were with hypertension, 17.3% patients were with high TC, 30.7% patients were with high TG, 26.9% patients were with low HDL-C, and 27.8% patients were with high LDL-C. Conclusion High incidence of hypertension, poor blood sugar control, and lipid metabolism disorders are prominent metabolic disorders in RA patients with T2DM. Clinicians, particularly rheumatologists, need to give adequate attention to these conditions.
出处
《中华风湿病学杂志》
CAS
CSCD
北大核心
2016年第2期88-92,共5页
Chinese Journal of Rheumatology
基金
国家自然科学基金（81273284,81471607）
上海市科委基础研究重点课题（12DZl9310-03）
关键词
关节炎
类风湿
2型糖尿病
代谢紊乱
Arthritis rheumatoid, Type 2 diabetes
Metabolic disorders
