来源：风湿病与关节炎,2022,11（7）:18-23.

4238例类风湿关节炎共病的临床研究（临床研究）

杨显娜¹，包路艳¹，唐海倩¹，凌　丽¹，孟凡雨¹，殷建美¹，张昊喆¹，彭江云²

　　【摘　要】目的：总结类风湿关节炎患者共病的临床特点并分析其影响因素，为临床防治提供一定依据。方法：分析云南中医药大学第一附属医院4238例住院类风湿关节炎患者的共病情况，总结类风湿关节炎患者共病的临床特点。结果：类风湿关节炎患者共病中骨骼系统疾病1929例（45.52%），肺部疾病1555例（36.69%），心血管系统疾病1145例（27.02%），血液系统疾病754例（17.79%），其他疾病：重叠综合征310例（7.31%）。男性肺间质纤维化（21.20%）、肺部感染（6.60%）、冠心病（2.47%）、低蛋白血症（7.77%）的患病率高于女性。在中医证候中，占比最多的证型为风寒湿痹证，共2243例（52.93%）。结论：类风湿关节炎共病的发生率高。共病中最多见的是骨骼系统疾病，其次是肺部疾病和心血管系统疾病。类风湿关节炎女性比男性多发，但男性合并肺间质纤维化、肺部感染、冠心病、低蛋白血症的患病率高于女性。云南地区风寒湿痹证为当地类风湿关节炎患者最常见的中医证候。

　　【关键词】　类风湿关节炎；共病；风寒湿痹证；临床特点

Clinical Study on 4238 Cases of Rheumatoid Arthritis Comorbidity

YANG Xian-na,BAO Lu-yan,TANG hai-qian,LING Li,MENG Fan-yu,YIN Jian-mei,ZHANG Hao-zhe,

PENG Jiang-yun

　　【ABSTRACT】Objective:To summarize the clinical characteristics of rheumatoid arthritis patients with comorbidity and analyze its influencing factors,so as to provide some basis for clinical prevention and treatment.Methods:The comorbidity of 4238 hospitalized patients with rheumatoid arthritis in the First Affiliated Hospital of Yunnan University of traditional Chinese medicine was analyzed retrospectively,and the clinical characteristics of comorbidity of patients with rheumatoid arthritis were summarized.Results:Among the patients with rheumatoid arthritis,there were 1929 cases of bone system diseases（45.52%）,1555 cases of lung diseases（36.69%）,1145 cases of cardiovascular diseases（27.02%）,754 cases of hematological diseases（17.79%）,and 310 cases of overlap syndrome（7.31%）.The prevalence of pulmonary interstitial fibrosis（21.20%）,pulmonary infection（6.60%）,coronary heart disease（2.47%）,and hypoproteinemia（7.77%）in men was higher than that in women.In TCM syndromes,the syndrome type with the largest proportion is wind cold dampness arthralgia syndrome,with a total of 2243 cases（52.93%）.Conclusion:The incidence of rheumatoid arthritis comorbidity is high.The bone system is the most common comorbidity,followed by lung disease and cardiovascular disease.Rheumatoid arthritis occurs more frequently in women than in men,but the prevalence of pulmonary interstitial fibrosis,pulmonary infection,coronary heart disease and hypoproteinemia in men is higher than that in women.Wind cold dampness arthralgia syndrome in Yunnan is the most common TCM syndrome in local rheumatoid arthritis patients.

　　【Keywords】 rheumatoid arthritis;Comorbidity;wind cold dampness arthralgia syndrome;clinical features