| 摘要: |
| 目的 利用Hitales数据采集分析平台初步探索强直性脊柱炎（AS）的临床特征。方法 回顾性分析2005年1月至2018年6月于海军军医大学（第二军医大学）第一、第二附属医院风湿免疫科住院部治疗的2 692例AS患者的14 220例次病历资料，通过Hitales平台收集患者的人口学资料、人类白细胞抗原-B27（HLA-B27）检查结果、临床表现（首发症状、中轴及外周关节受累情况）、特殊表现、用药情况等。结果 AS患者中男2 094例，女598例，男女比例为3.5：1。男性患者的首发年龄小于女性［（28.27±12.94）岁vs（33.46±14.01）岁，P<0.01］，>45岁的患者确诊用时短于<20岁、21～45岁年龄段的患者［0.63（0.00，5.37）年vs 0.92（0.20，6.91）年、1.87（0.10，7.13）年，P均<0.01］。男性和女性AS患者的HLA-B27阳性率相近，分别为70.30%（715/1 017）和70.16%（221/315）。HLA-B27阴性AS患者的首发年龄、确诊用时与HLA-B27阳性患者相比差异均无统计学意义（P均>0.05）。61.29%（1 650/2 692）的AS患者首发症状为中轴关节症状，首发症状为外周关节症状的AS患者较年轻。男性AS患者髋关节受累的发生率高于女性［8.17%（171/2 094）vs 4.68%（28/598），P<0.01］。高血压是AS患者最常见的合并症（19.66%，209/1 063）。女性AS患者骨质疏松在合并症中的占比高于男性［13.26%（35/264）vs 7.76%（62/799），P<0.01］。2 692例AS患者中2 602例（96.66%）通过药物控制病情，其中2 062例（79.25%）使用过非甾体抗炎药。结论 AS的高发人群是青年男性，高血压是AS患者最常见的合并症，女性AS患者较男性更易罹患骨质疏松。非甾体抗炎药作为AS的一线治疗药物仍被广泛使用。 |
| 关键词: 强直性脊柱炎 Hitales平台 临床表现 大数据 |
| DOI：10.16781/j.CN31-2187/R.20211056 |
| 投稿时间：2021-10-21修订日期：2022-01-06 |
| 基金项目:上海市临床重点专科项目（shslczdzk02602），国家自然科学基金（81801620）. |
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| Preliminary exploration of clinical characteristics of ankylosing spondylitis based on Hitales platform |
| BIAN Jian-ye1△,LIU Xin1△,ZHU Chang-hao1,WAN Wei2,JIANG Lei1,XU Hu-ji1* |
(1. Department of Rheumatology and Immunology, The Second Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200003, China;
2. Department of Rheumatology and Immunology, The First Affiliated Hospital of Naval Medical University(Second Military Medical University), Shanghai 200433, China
△Co-first authors.
* Corresponding author) |
| Abstract: |
| Objective To preliminarily explore the clinical characteristics of patients with ankylosing spondylitis (AS) using Hitales platform (a clinical data analysis platform). Methods The clinical data (14 220 medical records) of 2 692 AS patients, who were admitted in The First or Second Affiliated Hospitals of Naval Medical University (Second Military Medical University) from Jan. 2005 to Jun. 2018, were retrospectively analyzed. The demographic data, human leukocyte antigen-B27 (HLA-B27) examination results, clinical characteristics (first symptom, axial joint and peripheral joint involvement), special manifestations and medication were collected through Hitales platform. Results The AS patients included 2 094 males and 598 females. The male to female ratio was 3.5:1. The onset age of male patients was significantly younger than that of female patients ([28.27±12.94] years vs[33.46±14.01] years, P<0.01), and the average diagnosis time of patients over 45 years old was significantly shorter than those of patients of <21 years and 21-45 years (0.63[0.00, 5.37] years vs 0.92[0.20, 6.91] years and 1.87[0.10, 7.13] years, both P<0.01). The positive rates of HLA-B27 in female and male AS patients were similar, which were 70.30% (715/1 017) and 70.16% (221/315), respectively. There were no significant differences in the onset age or diagnosis time between HLA-B27 negative and positive patients (both P>0.05). The first symptom was axial joint symptom in 61.29% (1 650/2 692) of AS patients, and the patients with peripheral joint symptom were younger. The incidence of hip involvement in male AS patients was higher than that in female patients (8.17%[171/2 094] vs 4.68%[28/598], P<0.01). Hypertension was the most common complication in AS patients (19.66%, 209/1 063). The proportion of osteoporosis in female AS patients was higher than that in male patients (13.26%[35/264] vs 7.76%[62/799], P<0.01). Of the 2 692 AS patients, 2 602 (96.66%) were controlled by drugs, and 2 062 patients (79.25%) used non-steroidal anti-inflammatory drugs. Conclusion The incidence of AS is high in young men, hypertension is the most common complication, and female AS patients are more likely to suffer from osteoporosis than male AS patients. Non-steroidal anti-inflammatory drugs are still widely used as the first-line treatment drugs of AS. |
| Key words: ankylosing spondylitis Hitales platform clinical characteristics big data |
