Analysis Of The Related Factors Of Follow-up And Treat To Target Of Rheumatoid Arthritis In A Hospital

Objective: To retrospectively analyze the data of patients with rheumatoid arthritis（RA）admitted to the Department of Nephrology and rheumatology of the First Affiliated Hospital of Dali University in recent five years,and to explore the related factors affecting the follow-up and treat to target of RA patients in our hospital,so as to provide guidance for future clinical work.Method:1.This study retrospectively collected the general clinical data and relevant laboratory parameters of 1224 RA patients hospitalized in the Department of Nephrology and r-heumatology,the First Affiliated Hospital of Dali University from January 2016 to January 2021.2.Grouping and observation indicators:（1）1224 patients with RA were divided into follow up group（748 cases）and non-f ollow up group（476 cases）according to whether they returned to the hospital within 6months after discharge.The baseline data of patients in the two groups were compared f-or differences,and explore the factors affecting the follow up of RA patients;（2）The follow up group was divided into 3-month follow up group（607 cases,follow up in the 3rd month）and 6-month follow up group（269 cases,follow up in the 6th month）by taking the treatment for 3 months and 6 months as the observation points.Co-mpare the changes of C-reactive protein,anti-cyclic citrullinated peptide,erythrocyte sedimentation rate and rheumatoid factor at the initial treatment and 3 months and 6 months after treatment between the two groups;and according to the disease activity score in 28 joints（DAS28）criteria,Statistics of the two groups of patients with treat to target;（3）Using 6 months of treatment as the observation point,269 RA patients in the 6-month follow up group were divided into the target group（170 patients）and the non-tar get group（99 patients）according to the DAS28 criteria（target = DAS28 ≤ 3.2）,The gen-eral clinical data,laboratory parameters and the number of follow up within 6 months were compared between the two groups,to analyze the factors affecting the treat to target of RA.All data were statistically analyzed using SPSS 25.0 software,and P < 0.05 was co-nsidered statistically significant.Results:1.In this study,748 of 1224 patients with RA returned to the hospital within 6 mont-hs,and the follow-up rate was 61.11%;Logistic regression analysis showed that gender,residence,hospital for the first visit,education level and medical payment method were independent contributing factors for RA patient follow up（P < 0.05）,Among them,the residence traffic is more convenient,the education level is higher and the female patien-ts are higher,while the first visit to other hospitals and the patients who build files and cards and pay for the New Rural Cooperative Medical System are lower;2.（1）There were significant differences in CRP,anti-CCP,ESR,RF index values a-nd disease activity between 0 month of treatment and 3 months of treatment（P < 0.05）;there were significant differences between 0 month of treatment and 6 months of treatm-ent（P < 0.05）;there were significant differences between the 3-month follow up group and the 6-month follow up group（P < 0.05）;（2）In this study,the target rate of RA patients at 3 months after discharge was 29.98%,and the clinical remission rate was 14.33%;the target rate at 6 months after dischar-ge was 63.20%,and the clinical remission rate was 33.46%;3.Compared with the non-target group,the target group had younger age,higher education level and more follow-up times,lower ESR and CRP,and the proportion of a nti-CCP and RF negative patients higher,and the differences were statistically significan-t（P < 0.05）;Logistic regression analysis showed that follow-up times,ESR,and RF w-ere independent contributing factors for the treatment of RA reaching the target.Conclusion:1.In this study,the follow-up rate of RA patients within 6 months after discharge was 61.11%,which was higher than that in some domestic studies.Gender,residence,fi-rst hospital,education level and medical payment method were independent factors affecting the follow-up rate of RA patients;2.In this study,the treatment compliance rate of RA patients at 3 months of follow-up was 29.98%,and the compliance rate at 6 months of treatment was 63.20%（DAS28）,which was slightly higher than the domestic Average level of 60.74%;3.The follow up times,ESR and RF are independent factors affecting the treat-to-t arget of RA,and increased the follow up times,RF negativity,and low levels of ESR are conducive to RA treat-to-target.