摘要
目的:探讨住院急性痛风患者发热的危险因素。方法:对符合纳入标准的185例住院急性痛风患者资料进行回顾性分析,根据体温分为中高热组(n=25)、低热组(n=25)和无发热组(n=135例)。比较3组临床资料、炎症指标及用药的资料差异。再根据有无膝关节疼痛分为膝关节疼痛组(n=69)和无膝关节疼痛组(n=116)比较2组炎症指标及穿刺治疗差异。采用二元logistic回归分析住院痛风发热的危险因素。结果:3组在白细胞计数(9.2±2.3 vs.8.6±3.3 vs.7.7±2.5,P=0.022)、中性粒细胞百分比(77.7±4.0 vs.70.5±10.6 vs.67.7±12.1,P=0.001)、疼痛VAS评分[3(3.0,4.0) vs.2(2.0,3.0) vs.2(1.5,3.0),P=0.001]、C反应蛋白(c-reactive protein,CRP)[102(49,137) vs.36(22,83) vs.15(5,53),P=0.001]及血沉(erythrocyte sedimentation rate,ESR)[50(41,66) vs.28(16,45) vs.27(14,46),P=0.001]水平比较差异均有统计学意义,其中高热组在白细胞计数、中性粒细胞百分比比无发热组高(P=0.012、P=0.001);中高热组在疼痛VAS评分、CRP、ESR比无发热组及低热组高(P=0.001、P=0.001、P=0.001及P=0.014、P=0.033、P=0.011)。低热组使用非甾体抗炎药的比例高于无发热组(92%vs 68.1%,P=0.015)及中高热组(92%vs.60.0%,P=0.008)。3组在膝关节疼痛(56.0%vs.48.0%vs.31.9%,P=0.036)、第一足趾关节疼痛(6.0%vs.0.0%vs.25.9%,P=0.007)、上肢关节疼痛(40.0%vs.16.0%vs.17.8%,P=0.034)及多关节受累(56.0%vs.24.0%vs.25.9%,P=0.008)的比例比较差异均有统计学意义。有膝关节疼痛者ESR[43(21,56) vs.25(14,41),P=0.001]、CRP[45(11,115) vs.17(5,49),P=0.001]和关节腔局部治疗的比例(58.0%vs.6.9%,P=0.001)较无膝关节受累组高。logistic回归分析发现白细胞(OR=1.171,95%CI=1.037~1.323,P=0.011)、中性粒细胞百分比(OR=1.053,95%CI=1.020~1.087,P=0.002)、CRP(OR=1.015,95%CI=1.008~1.021,P=0.001)、血沉(OR=1.023,95%CI=1.008~1.039,P=0.003)、疼痛VAS评分(OR=1.674,95%CI=1.228~2.282,P=0.001)、膝关节疼痛(OR=2.428,95%CI=1.252~4.709,P=0.009)为�
Objective:To investigate the risk factors of fever in hospitalized patients with acute gout.Methods:The data of 185 hospitalized patients with acute gout meeting the inclusion criteria were retrospectively analyzed and divided into moderate and high fever group(n=25),low fever group(n=25) and no fever group(n=135) according to body temperature.The clinical data,inflammatory indicators and medication data were compared.Then the two groups were divided into knee pain group(n=69) and pain free group(n=116) according to the presence or absence of knee pain.The risk factors of hospitalized gout fever were analyzed by binary Logistic regression.Results:The white blood cell count in 3 groups was(9.2±2.3 vs.8.6±3.3 vs.7.7±2.5,P=0.022),neutrophil percentage(77.7±4.0 vs.70.5±10.6 vs.67.7±12.1,P=0.001),pain VAS score[3(3.0,4.0) vs.2(2.0,3.0) vs.2(1.5,3.0),P=0.001],c-reactive protein(102(49,137) vs.36(22,83) vs.15(5,53),P=0.001) and ESR levels50(41,66) vs.28(16,45) vs.27(14,46),P=0.001] were statistically significant.The white blood cell count and neutrophil percentage in the high fever group were higher than those in the no-fever group(P=0.012,P=0.001).The pain VAS score,CRP and ESR in moderate and high fever group were higher than those in no fever group and low fever group(P=0.001,P=0.001,P=0.001 and P=0.014,P=0.033,P=0.011).The proportion of NSAIDS used in low-fever group was higher than that in no-fever group(92% vs.68.1%,P=0.015) and medium-high fever group(92% vs.60.0%,P=0.008).In the three groups,knee pain(56.0% vs 48.0% vs.31.9%,P=0.036),first toe joint pain(6.0% vs.0.0% vs.25.9%,P=0.007),upper limb joint pain(40.0% vs.16.0% vs.17.8%,P=0.034) and multiple joint involvemen(t56.0% vs.24.0% vs.25.9%,P=0.008) were statistically significant.Proportion of ESR[43(21,56) vs.25(14,41),P=0.001],CRP[45(11,115) vs.17(5,49),P=0.001] and local treatment of joint cavity in patients with knee pain[(58.0% vs.6.9%),P=0.001] were higher than those without knee joint involvement.Logistic regression analysis showed that leukocytes
作者
黄艳
袁放
Huang Yan;Yuan Fang(Zhejiang Hospital,Zhejiang Hospital,Zhejiang University School of Medicine Department of Rheumatology and Clinical Immunology Zhejiang Hospital)
出处
《重庆医科大学学报》
CAS
CSCD
北大核心
2024年第3期351-356,共6页
Journal of Chongqing Medical University
