| Objective:Exploring the investigation of the severity extent of pain in RA combined with OP patients and the analysis of related influencing factors,so as to providing a theoretical basis for pain management in the course of RA combined with OP patients in clinical operation.Methods:From May 2021 to October 2022,230 sufferers who were diagnosed as rheumatoid arthritis in the Department of Immunorheumatology of a 3A nosocomium in Yan ’an and admitted to the nosocomium were picked,and all of them were in formation with the American College Of rheumatology(ACR)and the European Federation against rheumatism.According to the diagnostic criteria offered by EULAR),184 sufferers with other autoimmune conditions,impatient and slow in taking effect permeates,heart,liver,renal failure and other serious chronic sickness were excluded.Collect the general data of all the subjects,such as age,sex,weight,height,course of illness,the previous of smoking,the previous hormone use,Laboratory indicators include rheumatoid factor(RF),Anti-CCP,serum 25-hydroxyvitamin D(25(OH)D),serum albumin(ALB),serum calcium(Ga),serum phosphorus(P),red blood cells(RBC),hemoglobin(HB)and Interleukin(IL-6),erythrocyte sedimentation rate(ESR),C-reactive protein(CRP),discrepancy parts bone mineral density(BMD),VAS pain grade,figure of swollen joints(SJC)and destiny of tender joints(TJC),and 28 joint Disease Fuction Grade(DAS28)were calculated.According to the BMD or the case’s prreceding the previous of fragility fractures,they were separated into RA integated with OP group and RA without op group.According to the VAS ache grade,it can be separated light ache(1-3 points),medium ache(4-6 points)and fantasy ache(7-10 points).Univariate analysis,pluralistic Logistic regression were used to evaluate the relevant risk elements of ache severity extent in cases with RA integated with OP.Results:1.The 184 RA sufferers contained were analyzed and separated into RA without OP group and RA integated with OP group.In which,there were 31 males 34.8 percent and 58 females 65.2 percent in the RA without OP group,aged from 33 to 68 years,with an average age of(55.63±9.96)years;Wherein 42 males 44.2 percent and 53 females55.8 percent in RA integated with OP group,aged from 35 to 70 years,with an average age of(61.09±5.45)years.2.Among RA cases,there were 95 sufferers with OP,the incidence rate was 51.63percent;In which,25 cases have old fractures,including 10 cases of rib fractures,6 cases of femoral neck fractures,5 cases of thoracolumbar fractures,3 cases of tibia and fibula fractures and 1 case of radius fractures.3.Comparison of general information: The combined OP group had a remarkably important discrepancy in sickness duration compared to the non combined OP group(P<0.05).There was no remarkably important discrepancies between the two groups in terms of gender,age,BMI,smoking history,and hormone use history(P>0.05).4.Comparison of disease activity related indicators: The combined OP group showed taller than levels of TJC,DAS28,ESR,IL-6,and RF compared to the non combined OP group,with remarkably important discrepancies(P<0.05).There was no remarkably important discrepancy in SJC,CRP,and Anti CCP between the two groups(P>0.05).The presence of OP in RA sufferers may be correlated with TJC,DAS28,ESR,IL-6,and RF levels.5.Comparison with bone mass related indicators: There was no remarkably important discrepancy in serum Ga and P(P>0.05).The levels of serum ALB,RBC,HB,25(OH)D,lumbar spine BMD,neck of femur BMD,and articulatio coxae BMD in the group with OP were lower than those in the group without OP(P<0.05).It is suggested that serum ALB,RBC,HB,25(OH)D,lumbar spine BMD,neck of femur BMD,and articulatio coxae BMD may be related to RA complicated with OP.6.The VAS score of sufferers in the RA combined with OP group was taller than that in the RA not combined with OP group,and the discrepancy was remarkably important(P<0.05).Among them,there were 22 cases of light ache,48 cases of medium ache,and19 cases of serious ache in the non OP group.There were 14 cases of light pain,36 cases of medium pain,and 45 cases of serious pain in the combined OP group.7.The severity extent of pain in RA sufferers with OP was negatively correlated with lumbar BMD(r=-0.213,P<0.05),neck of femur BMD(r=-0.253,P<0.05),hip BMD(r=-0.287,P<0.05),and 25(OH)D(r=-0.512,P<0.001)(P<0.05);There is a positive correlation(P<0.05)with TJC(r=0.274,P<0.05),DAS28(r=0.508,P<0.001),and ESR(r=0.231,P<0.05).The severity extent of pain in RA sufferers without OP was negatively correlated with ALB(r=-0.285,P<0.05)and 25(OH)D(r=-0.512,P<0.001)(P<0.05);There is a positive correlation(P<0.05)with DAS28(r=0.629,P<0.001),ESR(r=0.269,P<0.05),and RF(r=0.295,P<0.05).8.Pluralistic logistic regression assay shows that:Among them,lumbar spine BMD(OR: 1.622,95% CI:-1.595 ～ 0.245,P < 0.05),neck of femur BMD(OR: 0.135,95% CI:-3.553 ～-0.453,P < 0.05),articulatio coxae BMD(OR: 0.420,95% CI:-2.004 ～ 0.267,P < 0.05),DAS28(OR: 2.669,95% CI: 0.459 ～ 1.504,P < 0.001)25(OH)D(OR: 0.839,95% CI:-1.104～-0.123,P<0.05)is an independent influencing element for the severity extent of pain in RA sufferers with OP.Conclusion:1.Lumbar BMD,neck of femur BMD,hip BMD,DAS28,25(OH)D are independent risk elements affecting the severity of ache in cases with RA integated with OP.2.The incidence of serious pain in RA patients with OP is taller.The severity extent of pain is positively correlated with TJC,DAS28,and ESR,and negatively correlated with lumbar BMD,neck of femur BMD,hip BMD,and 25(OH)D.3.The incidence of medium pain in RA patients without OP is taller,and the severity extent of pain is positively correlated with DAS28,ESR,RF,and negatively correlated with ALB and 25(OH)D. |
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