来源：风湿病与关节炎,2019,8（3）:16-21.

有盗汗与无盗汗的类风湿关节炎临床表现差异的研究（临床研究）

王颂歌，陈永前，纪　丽，娄玉钤

　　【摘　要】目的：探讨有盗汗与无盗汗的类风湿关节炎临床表现的差异。方法：将河南风湿病医院类风湿关节炎数据库（HFRA数据库）中收录的409例患者按有无盗汗分为有盗汗组和无盗汗组，采用SPSS 24.0软件分析2组在关节表现及关节外表现的区别。结果：409例类风湿关节炎患者中，有盗汗组105例，无盗汗组304例，通过对2组236个关节表现及关节外表现进行统计分析，结果2组间差异有统计学意义（P < 0.05）的临床表现共51项，其中①左腕柔韧感、右腕柔韧感、左近指柔韧感、右近指柔韧感、左膝柔韧感、右膝柔韧感、左踝柔韧感、右踝柔韧感、左腕活动受限，有盗汗组 < 无盗汗组；②有盗汗组 > 无盗汗组的临床表现较多且复杂，按关节表现和关节外表现分类如下，关节表现：左肩疼痛、右肩疼痛、左肘疼痛、右肘疼痛、肩锁关节疼痛、凉痛、沉痛、僵痛、麻痛、游走性痛、生气后加重、劳累加重、活动后减轻、左膝波动感、右膝波动感。关节外表现：全身乏力、活动后乏力、休息后乏力减轻、神倦懒动、五心烦热、动则汗出、口干、咽干、头面烘热、骨蒸潮热、少气懒言、心慌、胆怯、心神不宁、失眠、肢体麻木、纳少、肢体水肿、腰膝酸软、畏寒肢冷、肌肉萎缩、口苦、口黏腻、渴喜冷饮、头重如裹、两胁刺痛、干咳少痰。结论：有盗汗与无盗汗的类风湿关节炎临床表现不同。无盗汗组的关节外表现相对较少，而以关节表现较为突出；有盗汗组的关节表现和关节外表现均比较突出。

　　【关键词】　关节炎，类风湿；盗汗；关节表现；关节外表现；HFRA数据库；临床研究

On the Differences of Clinical Manifestations Between Rheumatoid Arthritis with and without Night Sweat

WANG Song-ge,CHEN Yong-qian,JI Li,LOU Yu-qian

　　【ABSTRACT】Objective:To investigate the differences of clinical manifestations between rheumatoid arthritis with and without night sweat.Methods:Four hundred and nine patients with rheumatoid arthritis in the HFRA database of Henan Rheumatoid Hospital were divided into two groups according to whether they had night sweat or not.The differences of joint manifestations and extraarticular manifestations between the two groups were analyzed by statistical software SPSS 24.0.Results:Among all the patients,105 cases in the night sweat group and 304 cases in the non-night sweat group.The clinical manifestations of 236 joint and extraarticular manifestations in both groups were statistically analyzed.Fifty-one clinical manifestations with significant differences（P < 0.05）in both groups were concluded as follows:①The following manifestations appear more frequently in the non-night sweat group than in the night sweat group:left wrist flexibility,right wrist flexibility,left proximal finger flexibility,right proximal finger flexibility,left knee flexibility and right knee flexibility,left ankle flexibility,right ankle flexibility,and limited movement of left wrist.②Clinical manifestations more frequently appearing in the night sweat group than the non-night group are more complicated.According to the joint manifestations and extraarticular manifestations,they were classified as follows:left shoulder pain,right shoulder pain,left elbow pain,right elbow pain,acromioclavicular joint pain,cool pain,heavy pain,stiff pain,numb pain,migratory pain,aggravation after anger,aggravation after fatigue,alleviation after exercise,left knee fluctuation,and right knee fluctuation all belong to joint manifestations;while extra-articular manifestations include general fatigue,fatigue after exercise,alleviation of fatigue after rest,fatigue and laziness,vexing heat in the five centers（chest,palms and soles）,movement-caused sweating,dry mouth,dry throat,hot flashes in head and face,steaming bone and tidal fever,weak breathing and no desire to speak,panic,timidity,restlessness,insomnia,limb numbness,no desire to eat,swelling of limbs,weak and sour waist and knee,fear of cold and cool limbs,muscle atrophy,bitter mouth,sticky mouth,strong desire for cold drinks,heavy head like being wrapped,tingling pain on both sides,and dry cough with less phlegm.Conclusion:The clinical manifestations of rheumatoid arthritis with and without night sweat are different.Extra-articular manifestations were relatively fewer in the non-night sweat group,but more prominent in joint manifestations.Joint and extra-articular manifestations were more prominent in the night sweat group.

　　【Keywords】 arthritis,rheumatoid;night sweat;joint manifestations;extra-articular manifestations;HFRA database;clinical research