目的 探讨系统性硬化病(SSc)合并关节炎的临床特征.方法 横断面分析SSc合并关节炎患者的临床表现和实验室检查资料.结果 248例SSc患者发病年龄(37.1±13.7)岁,102例合并关节炎,发病率为41.1%.SSc合并关节炎者关节痛(95.1%)、肌无力(38.2%)、活动后气短(60.8%)及间质性肺疾病(64.7%)的发生率高于SSc未合并关节炎者(15.1%、24.7%、45.2%、49.3%),差异有统计学意义(P值均<0.05).SSc合并关节炎者C反应蛋白升高者比例(61.4%)、抗Sm抗体阳性率(11.4%)、抗CCP抗体阳性率(28.1%)高于SSc未合并关节炎者(43.9%、2.5%、2/16;P值均=0.01).两者间在Rodnan皮肤硬皮评分、指端溃疡、肺动脉高压和6分钟步行距离试验比较差异无统计学意义(P值均>0.05).结论 SSc合并关节炎的发生率高,且可能与疾病炎症程度和继发间质性肺疾病有相关性,临床医生应重视SSc合并关节炎的早期识别.
Objective To explore the prevalence and independent influencing factors of arthritis in Chinese patients with systemic sclerosis(SSc).Methods A total of 248 SSc patients were enrolled in this prospective cross-sectional study in Peking Union Medical College Hospital.Demographic,clinical and laboratory data were compared in arthritis group and non-arthritis group.Results Of 248 Chinese SSc patients,mean age of onset was (37.1 ± 13.7) years old and disease duration was (7.4 ± 5.2) years.Overall prevalence of arthritis was 41.1% (102/248).The presence of arthralgia(95.1% vs 15.1%),muscle weakness(38.2% vs 24.7%),short of breath (60.8% vs 45.2%),and intestinal lung disease (64.7% vs 49.3%) occurred more frequently in patients with arthritis than those without arthritis (P 〈0.05).The elevation of C reactive protein,anti-Sm and anti-cyclic citrullinated peptide were more common in arthritis group than in non-arthritis group(61.4% vs 43.9%,11.4% vs 2.5% and 28.1% vs 2/16,respectively).There were no obvious differences in the Rodnan score,digital ulcers,pulmonary arterial hypertension,and six-minute walk test between two groups(P 〉 0.05).Conclusion This study reveals the significant prevalence of arthritis in a large cohort of SSc patients in China.Compared to non-arthritis patients,the SSc patients with arthritis have a more severe inflammation reaction and a higher rate of intestinal lung disease.