Ann Rheum Dis：类风湿关节炎全髋或膝关节成形术后的修复、假体关节感染和死亡率的预测指标

2017-11-03 xiangting MedSci原创

与THA/TKA后的OA患者相比，RA患者的10年修复风险降低，而死亡风险和PJI风险升高。

这项研究在以下人群中探讨了全髋/全膝关节成形术（THA/TKA）后10年修复风险和1年假体关节感染（PJI）风险的预测指标：（1）类风湿关节炎（RA）患者与骨关节炎（OA）患者比较；（2）与未治疗的患者相比，在手术前90天内用生物性疾病改善抗风湿药（bDMARD）治疗的RA患者。

研究人员使用丹麦国家患者登记、DANBIO风湿病登记（RA特异性混杂因素和治疗集）和丹麦髋关节和膝关节成形术登记进行基于登记的队列研究。使用生存分析来计算混杂因素调整的亚HRs（HRR）和HRs。

总共有3913例进行THA/TKA的RA患者与120 499例OA患者进行比较。RA患者修复的风险降低（SHR 0.71（0.57-0.89）），但PJI风险（SHR = 1.46（1.13-1.88））和死亡风险升高（HR = 1.25（1.01-1.55））。在DANBIO中，1946例进行THA/TKA的RA患者中有345例在手术前90天内接受了bDMARD治疗。与非治疗组相比，bDMARD治疗组患者的修复风险（SHR = 1.49（0.65-3.40）），PJI（SHR = 1.61（0.70-3.69））和死亡风险均没有显著升高（HR = 0.75（0.24-2.33））。糖皮质激素暴露（HR = 2.87（1.12-7.34））和升高的DAS28（HR = 1.49（1.01-2.20））是死亡率的危险因素。

与THA/TKA后的OA患者相比，RA患者的10年修复风险降低，而死亡风险和PJI风险升高。在这项研究中，使用bDMARD与PJI或死亡的风险显著升高无相关性。糖皮质激素暴露和疾病活动性增加与死亡风险升高相关。

原始出处：

Rene Lindholm Cordtz, et al. Predictors of revision, prosthetic joint infection and mortality following total hip or total knee arthroplasty in patients with rheumatoid arthritis: a nationwide cohort study using Danish healthcare registers. Ann Rheum Dis. 02 November 2017.

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2018-07-25 ZGMFX24A

#成形术#

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2018-06-04 cmj8wellington

#Dis#

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2017-11-05 lmm397

#关节炎#

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2017-11-05 ms4964546379600229

#类风湿#

47 0
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2017-11-05 anminleiryan

#预测指标#

58 0
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2017-11-05 lanyan20020088

#假体#

54 0
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2017-11-05 xuruicheng

#风湿关节炎#

43 0

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