新成立风湿免疫科5年住院患者疾病谱和临床特征分析

梁冬宾; 陶丽华; 徐婧; 郭倩; 李记; 石连杰

doi:10.16766/j.cnki.issn.1674-4152.001988

新成立风湿免疫科5年住院患者疾病谱和临床特征分析

doi: 10.16766/j.cnki.issn.1674-4152.001988

北京大学国际医院风湿免疫科，北京 102206

基金项目:

国家自然科学基金 81501396

北京大学国际医院院内基金 YN2017QX01

北京大学国际医院院内基金 YN2020ZD01

详细信息

通讯作者:
石连杰, E-mail: shilianjie1999@163.com

中图分类号: R593.2
计量
- 文章访问数: 264
- HTML全文浏览量: 87
- PDF下载量: 5
- 被引次数: 0
出版历程
- 收稿日期: 2021-01-12
- 网络出版日期: 2022-02-16

A five-year analysis of disease spectrum and clinical features of rheumatic inpatients in a new general hospital

Department of Rheumatology and Immunology, Peking University International Hospital, Beijing 102206, China

摘要

摘要: 目的通过对新成立的三级医院风湿科住院患者病种和临床特征分析，了解我国当前风湿免疫科住院患者的疾病谱分布和患者的一般特征。方法收集北京大学国际医院2015年1月—2019年12月风湿免疫科住院患者的性别、年龄、诊断、住院时长等临床资料，进行统计描述和分析。结果床位共22张，累计出院2 229人次，非重复住院患者共计1 236例。年龄(51.14±16.74)岁，其中≤65岁患者947例(76.62%)，女∶男=1.81 ∶ 1。主要病种构成：类风湿关节炎占25.29%，干燥综合征占11.30%，系统性红斑狼疮占8.59%，痛风占8.43%，骨关节炎占7.65%，脊柱关节炎占5.70%，其他如炎性肌病、系统性硬化症等病种占比均 < 3%。年住院人次持续增长(56、282、542、595、752)，但重复住院患者占比随之增加，于建科第3年新收治住院患者数增速减缓并呈现相对下滑。住院时长以炎性肌病最长[(19.79±11.86)d]，系统性硬化症次之[(16.54±8.48)d]。因病情需要重复住院的患者比例类风湿关节炎为8.64%，炎性肌病和系统性硬化症分别为32.14%和34.60%，均显著高于前者(均P < 0.001)。结论风湿免疫科住院患者年龄多 < 65岁，女性居多，关节炎性疾病仍是主要住院病种，住院天数偏长和因病情需要重复住院的是炎性肌病和系统性硬化症。
- 风湿性疾病 /
- 住院患者 /
- 疾病谱 /
- 构成比
Abstract: Objective To understand the disease spectrum distribution and general characteristics of inpatients in the Department of Rheumatology and immunology in China. Methods The clinical data of inpatients in the Department of Rheumatology and Immunology of Peking University International Hospital from January 2015 to December 2019, including gender, age, diagnosis and length of stay, were collected for statistical description and analysis. Results There were 22 beds, 229 patients discharged in total, and 1 236 non-repeat inpatients. The mean age was (51.14±16.74) years. Of all the patients, 947 patients were no more than 65 years (76.62%). The ratio of female to male was 1.81 ∶ 1. The most frequent rheumatic diseases inpatient was following, RA 25.29%, SS 11.30%, SLE 8.59%, Gout 8.43%, OA 7.65%, SpA 5.70%, and each of the other rheumatic diseases was less than 3%. The number of discharged patients increased year by year, with 56, 282, 542, 595 and 752 cases in each year, respectively. However, the number of repetitive inpatients increased. Different rheumatic diseases showed different hospital days, and patients with IIM need the longest hospital days [(19.79±11.86) d], and the average length of hospital stay of SSc was (16.54±8.48) days. The proportion of RA patients who were admitted to hospital repeatedly was 8.64%, but this proportion of IIM patients and SSc patients was 32.14% and 34.60%, respectively (all P < 0.001). Conclusion Most of the rheumatic inpatients were female and less than 65 years. Arthritis disease was still the main type of hospitalization in rheumatic disease. Patients with IIM or SSc need longer hospital stay and show a higher proportion of repeated hospitalization than patients with other rheumatic diseases.
- Rheumatic disease /
- Inpatients /
- Disease spectrum /
- Proportion

HTML全文

图 1 风湿免疫科住院患者病种分布

注：Others包括木村病、坏死性淋巴结炎、结节性红斑、冷球蛋白血症及风湿热等。

下载: 全尺寸图片幻灯片

图 2 风湿免疫建科前5年每年住院人次和住院人数汇总

下载: 全尺寸图片幻灯片

图 3 住院患者的年龄分布及性别构成特征

注：A为不同年龄阶段的患者构成比；B为不同性别住院患者的年龄对比，男性和女性患者年龄差异无统计学意义。

下载: 全尺寸图片幻灯片

图 4 不同风湿性疾病的住院时长对比

注：10种疾病住院时长差异有统计学意义(P < 0.05)。

下载: 全尺寸图片幻灯片

表 1 需反复住院诊治的风湿性疾病的重复住院情况分析

疾病种类	总重复住院率(%)	χ²值	P值	因病情所需的重复住院率(%)	χ²值	P值
RA	13.89(45/324)			8.64(28/324)
SS	15.07(22/146)	0.115^a	0.735	10.27(16/146)	0.637^a	0.425
SLE	19.09(21/110)	1.732^a	0.189	12.70(14/110)	1.568^a	0.211
AAV	34.29(12/35)	9.839^a	0.002	11.43(4/35)	0.056^a	0.812
IIM	46.43(13/28)	19.829^a	< 0.001	32.14(9/28)	12.737^a	< 0.001
SSc	34.60(9/26)	6.415^a	0.011	34.60(9/26)	14.538^a	< 0.001
TA	41.67(5/12)	5.027^a	0.025	25.00(3/12)	2.002^a	0.157
注：^a为与RA比较。

下载: 导出CSV

参考文献(16)

[1]	张奉春. 第二次全国风湿免疫专科医师调查报告[J]. 中华临床免疫和变态反应杂志, 2014, 8(3): 165-169. https://www.cnki.com.cn/Article/CJFDTOTAL-OZHL201403001.htm
[2]	王涛, 李志军. 类风湿关节炎的诊断与治疗[J]. 中华全科医学, 2020, 18(2): 170-171.
[3]	MATHEW A J, DANDA D, CONAGHAN P G. MRI and ultrasound in rheumatoid arthritis[J]. Curr Opin Rheumatol, 2016, 28(3): 323-329. http://www.onacademic.com/detail/journal_1000039412750810_73ae.html
[4]	YE H, SU Y, LI R, et al. Comparison of three classification criteria of rheumatoid arthritis in an inception early arthritis cohort[J]. Clin Rheumatol, 2016, 35(10): 2397-2401. doi: 10.1007/s10067-016-3281-2
[5]	ZHANG S, WANG Y, PENG L, et al. Comparison of clinical features in HLA-b27 positive and negative patients with axial spondyloarthritis: Results from a cohort of 4, 131 patients[J]. Front Med(Lausanne), 2020, 7: 609562. http://www.researchgate.net/publication/347900110_Comparison_of_Clinical_Features_in_HLA-B27_Positive_and_Negative_Patients_With_Axial_Spondyloarthritis_Results_From_a_Cohort_of_4131_Patients
[6]	FANOURIAKIS A, KOSTOPOULOU M, CHEEMA K, et al. 2019 Update of the joint european league against rheumatism and european renal association-european dialysis and transplant association(EULAR/ERA-EDTA) recommendations for the management of lupus nephritis[J]. Ann Rheum Dis, 2020, 79(6): 713-723. doi: 10.1136/annrheumdis-2020-216924
[7]	ARINGER M, COSTENBADER K, DAIKH D, et al. 2019 European League Against Rheumatism/American College of Rheumatology classification criteria for systemic lupus erythematosus[J]. Ann Rheum Dis, 2019, 78(9): 1151-1159. doi: 10.1136/annrheumdis-2018-214819
[8]	MARIAMPILLAI K, GRANGER B, AMELIN D, et al. Development of a new classification system for idiopathic inflammatory myopathies based on clinical manifestations and myositis-specific autoantibodies[J]. JAMA Neurol, 2018, 75(12): 1528-1537. doi: 10.1001/jamaneurol.2018.2598
[9]	SEROR R, BOWMAN S J, BRITO-ZERON P, et al. EULAR Sjogren's syndrome disease activity index(ESSDAI): A user guide[J]. RMD Open, 2015, 1(1): e000022. doi: 10.1136/rmdopen-2014-000022
[10]	谢长好, 李志军. 系统性红斑狼疮的诊断与治疗[J]. 中华全科医学, 2020, 18(4): 527-528. https://www.cnki.com.cn/Article/CJFDTOTAL-SYQY202004002.htm
[11]	SHIBOSKI C H, SHIBOSKI S C, SEROR R, et al. 2016 American College of Rheumatology/European league against rheumatism classification criteria for primary Sjogren's syndrome: A consensus and data-driven methodology involving three international patient cohorts[J]. Arthritis Rheumatol, 2017, 69(1): 35-45. http://smartsearch.nstl.gov.cn/paper_detail.html?id=a16c81cd33d2923e59416a82d4798256
[12]	LI Y, JIA X, SUN X, et al. Risk factors for cancer-associated myositis: A large-scale multicenter cohort study[J]. Int J Rheum Dis, 2021, 24(2): 268-273.
[13]	VOLKMANN E R, VARGA J. Emerging targets of disease-modifying therapy for systemic sclerosis[J]. Nat Rev Rheumatol, 2019, 15(4): 208-224. http://www.onacademic.com/detail/journal_1000041601885999_c7d9.html
[14]	VACCHI C, SEBASTIANI M, CASSONE G, et al. Therapeutic options for the treatment of interstitial lung disease related to connective tissue diseases. a narrative review[J]. J Clin Med, 2020, 9(2): 407. http://www.researchgate.net/publication/339074498_Therapeutic_Options_for_the_Treatment_of_Interstitial_Lung_Disease_Related_to_Connective_Tissue_Diseases_A_Narrative_Review
[15]	MANFREDI A, SEBASTIANI M, CERRI S, et al. Prevalence and characterization of non-sicca onset primary Sjogren syndrome with interstitial lung involvement[J]. Clin Rheumatol, 2017, 36(6): 1261-1268. http://smartsearch.nstl.gov.cn/paper_detail.html?id=5fb1bcb1076f285369dec2bcb3e994d1
[16]	ROCA F, DOMINIQUE S, SCHMIDT J, et al. Interstitial lung disease in primary Sjogren's syndrome[J]. Autoimmun Rev, 2017, 16(1): 48-54. http://smartsearch.nstl.gov.cn/paper_detail.html?id=8872cf04e04716f62c310183c0689a86