Case Analysis Of Hospitalized Patients With Rheumatoid Arthritis Of A Classified 3A Hospital In Qiqihaer City

Purpose:By summarizing,sorting out and concluding the clinical data of the patients with rheumatoid arthritis in a Grade-A Tertiary Hospital of Qiqihar city,we analyzed the demographic characteristics,clinical symptoms,laboratory examination indexes,and medication utilization of the patients with rheumatoid arthritis,then investigated the correlation between different demographic characteristics,laboratory examination indexes and disease activity so as to provide reference for clinical diagnosis,prevention and treatment of rheumatoid arthritis.Methods:A total of 1740 patients with rheumatoid arthritis who were hospitalized for the first time from January 2014 to December 2017 in a Grade-A Tertiary Hospital in Qiqihar City were selected as research subjects.Clinical data were collected and analyzed retrospectively(including demographic characteristics,clinical symptoms,combined disease,laboratory indicators,and medication utilization etc.).Epidata 3.0 was used to establish a database,and IBM SPSS 24.0 was used for statistical analysis.Results:1.Of the 1740 cases of rheumatoid arthritis,1544(88.7%)were females and 196(11.3%)were males.2.The main joint manifestations in patients with rheumatoid arthritis were arthralgia(96.0%),joint tenderness(96.0%),joint swelling(90.6%),and morning stiffness(88.2%).The index of arthralgia,tenderness and swelling of joints increased gradually with the severity of disease activity(P < 0.001).The extra-articular manifestations were most in weakness(21.5%)and dryness of mouth/eye(12.8%).3.The top three diseases associated with rheumatoid arthritis are anemia(16.2%),hypertension(16.0%),osteoporosis(13.3%)and Sjogren's syndrome(11.0%).4.The relevance ratio of thrombocytosis increased with the aggravation of disease activity(P < 0.001).Hemoglobin levels decreased gradually with the severity of disease activity(P < 0.001).The relevance ratio of anemia was 17.9%,11.5% and 22.5% respectively in the low,moderate and severe disease activity groups,and the difference was statistically significant(P=0.001).The relevance ratio of anti-ENA positive was 0.3%,3.3% and 3.1% in groups with low,moderate and severe diseases activity respectively.With the increase of disease activity,the positive detection rate showed an overall upward trend(P < 0.05).5.With the aggravation of disease activity,the detection rate of rheumatoid factor positive in patients with rheumatoid arthritis showed an upward trend,the detection rate was 62.3%,65.8% and 88.3% respectively.The relevance ratio of CRP elevation in low,moderate and severe disease activity groups were 33.8%,61.9% and 71.9% respectively,which showed an upward trend with the increase of disease activity(P < 0.001).6.The relevance ratio of elevated ESR in low,moderate and severe cases were 60.6%,93.7% and 85.6% respectively.The detection rates of anti-CCP antibodies positive were 68.4%,90.2% and 87.9% in low,moderate and severe cases respectively.With the aggravation of disease activity,the relevance ratio of rheumatoid erythrocyte sedimentation rate elevation and anti-CCP antibody positive in patients with rheumatoid arthritis increased overall(P < 0.001).7.The platelet lymphocyte ratio and neutrophil to lymphocyte ratio increased gradually with the increase of disease activity(P < 0.001).The detection rates of increased ischemic modification protein were 6.3%,11.7% and 58.9% in low,moderate and severe disease activity groups respectively.The detection rates increased significantly with the increase of disease activity(P < 0.001).8.In terms of liver function and kidney function,the detection rates of albumin decrease,GGT elevation,urea elevation,creatinine and uric acid elevation increased with the severity of disease activity(P < 0.001),and the detection rate of elevated AST was decreased with the increase of disease activity(P < 0.001).Conclusion:1.The detection rate of platelet elevation and anti-ENA positive was increasing with the aggravation of disease activity of rheumatoid arthritis,while the level of hemoglobin was decreasing with the aggravation of disease activity.2.With the increase of RA activity,the detection rate of C-reactive protein,rheumatoid factor positive,anti-CCP positive and elevated ESR was increasing.3.The platelet lymphocyte ratio and neutrophil to lymphocyte ratio increased gradually with the aggravation of disease activity.The detection rates of increased ischemic modification protein were increased significantly with the aggravation of disease activity(P < 0.001).These results suggest that the platelet lymphocyte ratio,neutrophil to lymphocyte ratio,and ischemic modification protein are sensitive indicators of RA disease activity.