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J Rheumatol:银屑病关节炎患者矫形外科手术的发生率和预测因素

2018-09-02 xiangting MedSci原创

20%的PsA患者需要手术治疗。研究发现,尽管治疗方法有所变化,但PsA患者的预后并没有改变矫形外科手术的风险。

这项研究旨在探讨银屑病关节炎(PsA)患者矫形外科手术的发生率,以及患者特征、诊断时间和治疗是如何影响手术需求的。

研究人员回顾了挪威卑尔根Haukeland大学医院1432名疑诊PsA患者的病史。590名患者(平均年龄49岁,52%女性)有充足的记录信息并确诊为PsA,将这些患者纳入研究。从医院的行政病历中获得相关的矫形外科手术信息。完成生存分析以评估不同因素对手术风险的影响,例如诊断年份、年龄、性别、影像学改变、疾病活动性和治疗。 

117名患者共进行了171次手术(25%为滑膜切除术、15%为关节融合术、53%为假体手术)。以下因素都会增加手术风险:女性[相对风险(RR)1.9,p=0.001]、诊断时年龄≥70岁(RR 2.4,p=0.001)、初始X线片有关节炎(RR 2.2,p=0.006)、最大红细胞沉降率30-59mm/h(RR 1.6,p=0.026)。诊断的时间对结局没有影响。在不包括髋关节和膝关节置换术的手术亚组分析中,早期诊断(1954-1985 vs 1999-2011)是一个危险因素(RR 2.1,p=0.042)。抗风湿治疗随时间有着显著变化。

20%的PsA患者需要手术治疗。研究发现,尽管治疗方法有所变化,但PsA患者的预后并没有改变矫形外科手术的风险。可能的解释是一般人群中大关节置换的增多。

原始出处:

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    2018-10-01 衣带渐宽

    学习

    0

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createdTime=Sun Sep 02 20:37:20 CST 2018, time=2018-09-02, status=1, ipAttribution=)]
  5. 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topicId=null, topicList=[TopicDto(id=30113, encryptionId=57a53011364, topicName=关节炎)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=f90281, createdName=lmm397, createdTime=Tue Sep 04 08:17:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1343353, encodeId=ba7e134335339, content=<a href='/topic/show?id=d3ea4293676' target=_blank style='color:#2F92EE;'>#外科手术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=55, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=42936, encryptionId=d3ea4293676, topicName=外科手术)], attachment=null, authenticateStatus=null, createdAvatar=http://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTLGtr9t89oicQdQSIeKmOQic1weIWfibJ7H24XnT8ic9wiaUMTnXByenuwicOj8Jib42ibHXNptnuiaKthhiaVw/132, createdBy=ac342500190, createdName=ms7524819409032184, createdTime=Tue Sep 04 08:17:00 CST 2018, time=2018-09-04, status=1, ipAttribution=), 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createdTime=Sun Sep 02 20:37:20 CST 2018, time=2018-09-02, status=1, ipAttribution=)]
  6. 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createdTime=Sun Sep 02 20:37:20 CST 2018, time=2018-09-02, status=1, ipAttribution=)]
    2018-09-04 lmm397
  7. 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createdTime=Sun Sep 02 20:37:20 CST 2018, time=2018-09-02, status=1, ipAttribution=)]
  8. 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GetPortalCommentsPageByObjectIdResponse(id=342321, encodeId=78f434232102, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Sep 02 21:09:09 CST 2018, time=2018-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342317, encodeId=29b934231e29, content=学习了,非常有价值的临床经验,涨知识,受益匪浅,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/02/27/c53a212859edcad4f60a54feffff50bb.jpg, createdBy=67cf1525321, createdName=13718711b3m, createdTime=Sun Sep 02 20:37:20 CST 2018, time=2018-09-02, status=1, ipAttribution=)]
    2018-09-02 惠映实验室

    学习了,谢谢分享。

    0

  9. 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GetPortalCommentsPageByObjectIdResponse(id=342321, encodeId=78f434232102, content=学习了,谢谢分享。, beContent=null, objectType=article, channel=null, level=null, likeNumber=91, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://wx.qlogo.cn/mmopen/xkvRjYnJzzRJ2R0y7VhicibvkjPWHjIMmu4ZpKnE9cWAu4lVicS3uDUCfF4M4JWvrkrYfpb2KehPV0Ee29tPqyPEebBUibiaKhnvD/0, createdBy=f8412001184, createdName=惠映实验室, createdTime=Sun Sep 02 21:09:09 CST 2018, time=2018-09-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=342317, encodeId=29b934231e29, content=学习了,非常有价值的临床经验,涨知识,受益匪浅,感谢分享!, beContent=null, objectType=article, channel=null, level=null, likeNumber=85, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/02/27/c53a212859edcad4f60a54feffff50bb.jpg, createdBy=67cf1525321, createdName=13718711b3m, createdTime=Sun Sep 02 20:37:20 CST 2018, time=2018-09-02, status=1, ipAttribution=)]
    2018-09-02 13718711b3m

    学习了,非常有价值的临床经验,涨知识,受益匪浅,感谢分享!

    0

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