痛风增加化脓性关节炎风险

2018-01-31 佚名 生命新知

美国哈佛医学院麻省总医院风湿科的Sian Yik Lim和波士顿大学医学院的Na Lu、Hyon K. Choi在英国普通人群中开展的一项回顾性队列研究显示,成年人中的痛风会增加化脓性关节炎发病风险。

美国哈佛医学院麻省总医院风湿科的Sian Yik Lim和波士顿大学医学院的Na Lu、Hyon K. Choi在英国普通人群中开展的一项回顾性队列研究显示,成年人中的痛风会增加化脓性关节炎发病风险。

痛风是男性和绝经后女性最常见的炎症性关节炎。据调查,美国成人的痛风患病率约为3.9%,累及830万人。几十年来,痛风的患病率在美国和其他国家都上升了。与慢性关节炎有关的关节损害会增加个体发生化脓性关节炎的风险。几个大型人群队列研究均显示,类风湿关节炎很大程度上增加了化脓性关节炎的风险。与之类似,痛风患者发生化脓性关节炎的风险也可能很大。

为评估普通人群中痛风与化脓性关节炎风险的相关性,研究人员利用了英国的健康促进网络(The Health Improvement Network,THIN)数据库,纳入1995年1月1日~2013年12月31日登记的40岁以上人群,排除既往有化脓性关节炎、痛风、骨关节炎、类风湿关节炎和其他风湿病病史的患者。剩下的人群每出现一例痛风,就匹配五名无痛风者作为对照,随访终点为化脓性关节炎、死亡或失联。

最终产生的队列中有痛风者72073例,无痛风者358342例,平均年龄64岁,男性占74%。平均随访5.1年,痛风组发生化脓性关节炎90例,无痛风组发生化脓性关节炎166例,两组化脓性关节炎的发病率分别为0.24/1000人年和0.09/1000人年。校正年龄、性别和入组时间后,痛风患者发生化脓性关节炎的风险比为2.82;校正所有混杂因素后,该风险比为2.60。按性别、年龄和社会经济条件分层后,痛风和化脓性关节炎依然呈正相关。

该研究提示,痛风会增加化脓性关节炎的发病风险。美国威斯康星大学医学与公共卫生学院的院内感染专家Dennis G. Maki评论道,研究中的排除标准太多,可能低估了痛风患者中真实的化脓性关节炎风险。建议诊治关节炎时常规留取滑液标本筛查感染。有时候经验性抗感染治疗可能使滑液培养得不到阳性结果,进一步检查滑液的16S核糖体RNA聚合酶链式反应会有所帮助。

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    2018-03-10 shiranran110

    学习了

    0

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    2018-02-02 lmm397
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    2018-02-01 虈亣靌

    不确定性太多.需要努力学习

    0

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