Ann Rheum Dis:膝关节、髋关节和手部骨关节炎的静脉血栓风险

2020-09-20 xiangting MedSci原创

膝关节或髋关节骨关节炎与VTE风险升高相关,而不是手部骨关节炎。

骨关节炎是最常见的关节退行性疾病,中国40岁以上人群的患病率高达46.3%。骨关节炎是造成活动受限和关节置换的主要原因,而活动受限和关节置换又是静脉血栓栓塞(VTE)的重要危险因素。近日国际风湿病领域顶级期刊《Annals of the Rheumatic Diseases》上发表文章分析了膝关节、髋关节和手部骨关节炎与VTE风险之间的关联,并探讨了关节置换在这种关联中的介导作用。

研究者使用来自健康改善网络的数据进行了三项队列研究。每名膝关节(n=20 696)、髋关节(n=10 411)或手部(n=6329)骨关节炎患者根据年龄、性别、入组时间和体重指数与5名非骨关节炎患者进行匹配。分析了骨关节炎与VTE(肺栓塞和深静脉血栓)的关联。

研究发现,327例膝关节骨关节炎患者和951例非骨关节炎患者发生了VTE(每1000人年2.7 vs 2.0),多变量调整后的HR为1.38(95%CI为1.23-1.56)。膝关节骨关节炎通过膝关节置换对VTE的间接作用(HR)为1.07(95%CI为1.01-1.15),占其对VTE总作用的24.8%。髋关节骨关节炎患者的VTE风险高于非骨关节炎患者(每1000人年3.3 vs 1.8;HR = 1.83,95%CI 1.56-2.13)。通过髋关节置换的间接作用产生的HR为1.14(95%CI为1.04-1.25),占总作用的28.1%。手部骨关节炎患者与非骨关节炎患者之间的VTE风险没有显著差异(每1000人年1.5 vs 1.6; HR=0.88,95%CI 0.67-1.16)。

这项大型队列研究首次提供了证据表明,膝关节或髋关节骨关节炎与VTE风险升高相关,而不是手部骨关节炎。并且这种关联部分是由膝关节或髋关节置换介导的。

原始出处:

Chao Zeng. Risk of venous thromboembolism in knee, hip and hand osteoarthritis: a general population-based cohort study. Ann Rheum Dis. 16 September 2020.

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    2021-03-10 xue8602
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    2020-12-19 zhouqu_8
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    2021-08-09 lisa438
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    2020-09-22 lmm397

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