| Objective:To explore the clinical and laboratory characteristics of patients with rheumatoid arthritis concurrent with Sjogren's Syndrome,and to compare the clinical and laboratory characteristics beween the patients of RA-SS with RA and pSS.to understand the specific clinical manifestations and laboratory characteristics of RA-SS patients in order to find some potential independent risk factors for RA-SS patients,improve clinicians' early identification of RA-SS patients,and provide reference for their prevention and diagnosis,thereby reducing the disease burden of patients and improving the quality of life?Methods:Retrospectively collected clinical data of inpatients from the department of Rheumatology and Immunology of the Second Affiliated Hospital of Kunming Medical University from 2015 to 2019.235 patients met the inclusion and exclusion criteria,including RA:121 cases,RA-SS:44 cases,pSS:70 cases.Grouping the above three groups of patient data:pSS group,RA group,RA-SS group;SAS 9.4(Cary,NC)was used to analyze the data,and P<0.05 was considered statistically significant.Observing and summarizing the characteristics of the clinical manifestations,laboratory examinations and related diseases of RA-SS.Results:1.The gender difference in the three groups of patients was statistically significant,and the incidence was more common in women.The RA group had the lowest proportion of women.There was no statistical difference between the pSS group and the RA-SS group;the age difference between the three groups was statistically significant.The age of onset in the RA group was greater than that in the RA-SS group.There was no statistical difference between the pSS group and the RA-SS group.The difference in the course of disease among the three groups was statistically significant.The RA-SS group had the longest disease course.There was no statistical difference between the pSS group and the RA group.In terms of personal history,differences in smoking history and drinking history were statistically significant among the three groups.The smoking history and drinking history accounted for the largest proportion in the RA group,and there was no statistical difference between the pSS group and the RA-SS group.2.The differences in the symptoms of joint involvement,tenderness,swelling,morning stiffness,whether morning stiffness,weight loss,joint deformity,dental caries.oral ulcers,dry mouth,dry eyes were statistically significant(p<0.05).On the base of analysis and comparison,the RA-SS group had more joint involvement,tenderness,and swelling than the pSS group.The incidence of morning stiffness and joint deformity was high.and the morning stiffness time was longer.The RA-SS group had more joint tenderness and swelling than the RA group,and the incidence of dry mouth and dry eyes was higher.Through multivariate logistic regression analysis,the number of joints tenderness(OR=1.201)and swelling(OR=1.215)are independent risk factors for pSS with RA;dry mouth(OR=37.517)is independent risk factors for RA-SS.3.Anti-CCP antibody,AKA,APF,RFIgG,RFIgM,RFIgA,anti-SSA antibody,anti-SSB antibody,anti-RO-52 antibody,anti-p-ANCA antibody,anti-ribosome antibody,anti-centromere antibody,anti-mitochondrial M2 subtype antibody,ANA positive,ANA1:100,ANA1:320,ANA1:1000,ANA karyotype-cytoplasmic granule type,ANA karyotype-centromere type positive rate difference was statistically significant.On the base of analysis and comparison,the positive rate of anti-CCP antibody,AKA,APF,RFIgM,RFIgA in RA-SS group was higher than that in pSS group.The positive rate of anti-SSA antibody,anti-SSB antibody,anti-Ro-52 antibody,anti-ribosomal antibody,ANA,ANA titer(1:320,1:1000)in RA-SS group was higher than that of RA group.Through logistic regression analysis found that ANA titer(OR=2.611)and anti-SSA antibody positive(OR=19.115)were independent risk factors for RA-SS.4.Among the laboratory indexes of the three groups of patients,the differences in white blood cells,neutrophils,hemoglobin,platelets,albumin,serum iron,D-dimer,CRP,ESR,C3,C4,and RF values were statistically significant.On the base of analysis and comparison,the increase of D-dimer,ESR,CRP,RF and platelets in RA-SS group was more obvious than that in pSS patients,lower than that in RA patients.and the decrease of C3 and C4 was less than that in pSS patients.The level of serum iron decreased in RA group>RA-SS group>pSS group.Through logistic regression analysis showed that ESR(OR=1.022)and RF(OR=1.003)were independent risk factors for pSS with RA,and serum iron(OR=1.107)was independent risk factors for RA-SS.5.There were statistically significant differences in the incidence of pleural thickening,adhesion,osteoporosis,joint deformity,osteoarthritis,thyroid disease,anemia,and leukopenia among the three groups.On the base of analysis and comparison,The incidence of joint deformity,osteoarthritis,anemia,and leukopenia was higher in the RA-SS group than in the pSS group.Conclusions:1.The age of onset of RA-SS was smaller than that of RA,and the the disease course was longer than that of pSS and RA.2.The reduction of serum iron in RA-SS was more obvious than that in pSS,and lighter than that in RA.3.Joint deformities,osteoarthritis,hypoproteinemia and anemia in RA-SS are more common than in pSS,and the severity of anemia was more serious.Hypocomplementemia and leukopenia were rarer than pSS patients,and the degree of leukopenia was milder.4.The number of joint tenderness,swelling,RF titer,and erythrocyte sedimentation rate were independent risk factors for pSS with RA.When patients with pSS had arthritis symptoms and the greater number of joint tenderness and swelling,the higher the RF titer and the faster the blood sedimentation rate,the greater the possibility of accompanying RA.Dry mouth symptoms,positive anti-SSA antibody,ANA titer,and serum iron were independent risk factors for RA-SS.when RA patients had obvious symptoms of dry mouth and SSA antibodies positive or ANA positive and the higher the titer,the greater the possibility of accompanying SS. |
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