风湿性多肌痛1年内疾病复发相关影响因素分析

Analysis of Related Factors Influencing One-year Recurrence of Polymyalgia Rheumatica

  • 摘要: 目的 探讨影响风湿性多肌痛(polymyalgia rheumatica,PMR)1年内疾病复发的相关影响因素。方法 选取2019年1月至2024年6月在北京协和医院确诊并接受治疗的PMR患者为研究对象,比较疾病复发与未复发患者基线差异,并使用Lotistic回归方程分析疾病复发相关危险因素。结果 PMR患者平均发病年龄为(65.1±7.9)岁,男女比例1:3.3,发病至诊断平均时间(4.5±3.7)个月。基线ESR平均(67.0±29.2) mm/h,11例(17.2%)>100mm/h,CRP平均(57.9±51.3) mg/L。初始治疗激素使用率为95.3%,平均剂量(21.6±11.6) mg/d。随访12个月内,35.9%的患者出现疾病复发,首次复发的中位时间为(8.2±3.3)个月,3个月、6个月、9个月和12个月分别累计复发4例(6.3%)、9例(14.1%)、16例(25%)和23例(35.9%)。疾病复发与未复发患者的年龄(68.7±6.5)比63.2±8.1)岁,P=0.006和血ALB(36.8±4.2)比(39.4±5.0) g/L,P=0.046)比较差异均具有统计学意义。多因素Logistic回归分析发现,年龄对PMR复发的影响具有统计学意义(OR=1.094,95% CI:1.001~1.196,P=0.033),年龄每增加1岁,PMR的复发风险提升0.094倍,可能为PMR复发的独立危险因素。结论 PMR患者1年内疾病复发率较高,复发患者的年龄较大,血ALB水平较低;年龄可能为PMR患者1年内疾病复发的相关影响因素。

     

    Abstract: Objective To identify factors associated with the recurrence of polymyalgia rheumatica (PMR) within one year. Methods This study included 64 patients diagnosed with PMR at Peking Union Medical College Hospital between January 2019 and June 2024. The baseline characteristics of patients with and without recurrence were compared, and logistic regression analysis was performed to identify risk factors for recurrence. Results The mean age at onset was 65.1 ± 7.9 years, with a male-to-female ratio of 1:3.3. The average duration from onset to diagnosis was 4.5 ± 3.7 months. At baseline, the average erythrocyte sedimentation rate (ESR) was 67.0 ± 29.2 mm/h, with 11 patients (17.2%) having an ESR >100 mm/h, and the average C-reactive protein (CRP) level was 57.9 ± 51.3 mg/L. Corticosteroids were used as the initial treatment in 95.3% of patients, with an average dose of 21.6 ± 11.6 mg/day. During the 12- month follow-up, 35.9% of patients experienced recurrence, with the median time to first recurrence being 8.2 ± 3.3 months. The cumulative recurrence rates at 3, 6, 9, and 12 months were 6.3%, 14.1%, 25%, and 35.9%, respectively. Comparisons between patients with and without recurrence revealed significant differences in age (68.7 ± 6.5 vs. 63.2 ± 8.1 years, P=0.006) and serum albumin (ALB) levels (36.8 ± 4.2 vs. 39.4 ± 5.0 g/L, P=0.046). Multivariate logistic regression analysis identified age as a significant predictor of recurrence (OR=1.094, 95% CI:1.001-1.196, P=0.033), with each additional year of age increasing the risk of recurrence by 9.4%, suggesting that age may serve as an independent risk factor for recurrence. Conclusion The one-year recurrence rate of PMR is 35.9%. Older age and lower serum albumin levels are associated with recurrence, and age may be associated with disease recurrence within one year.

     

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