The association of rheumatoid arthritis and its treatment with sinus disease.
The association of rheumatoid arthritis and its treatment with sinus disease.
复制标题
类风湿性关节炎及其与鼻窦疾病的治疗的关联。
作者：
K. Michaud;F. Wolfe
目的
确定类风湿性关节炎（RA）患者的鼻窦疾病发生率是否增加，以及RA治疗是否改变了鼻窦疾病的风险。
方法
作为风湿性疾病结局纵向研究的一部分，2003年对7,243例RA、1,667例骨关节炎（OA）和447例纤维肌痛（FM）患者的重要鼻窦问题进行了评估。我们将重要的鼻窦问题定义为需要医生就诊的问题。
结果
所有患者中鼻窦疾病的终生患病率为42.9%。在过去6个月内，22.3%的RA患者、23.9%的OA患者和25.1%的FM患者因鼻窦问题就诊，分别有22.4%、23.9%和25.1%的患者因鼻窦问题接受处方药治疗。调整年龄和性别后，RA患者因鼻窦问题就诊的比例（22.1%）显著低于OA患者（24.8%）。所有患者中最强的鼻窦问题预测因素是过敏或哮喘史。鼻窦问题在依那西普使用者中更常见：比值比（OR）1.2; 95%置信区间（CI）：单变量1.0-1.4，多变量OR 1.2; 95% CI：1.0-1.4。柳氮磺吡啶（OR 0.7; 95%CI：0.5-0.9）和来氟米特（OR 0.8; 95%CI：0.7-1.0）对鼻窦问题具有保护作用。
结论
与OA和FM相比，RA患者的鼻窦问题减少。柳氮磺胺吡啶和来氟米特对鼻窦问题有轻微的保护作用，依那西普对鼻窦问题的风险略有增加。
OBJECTIVE
To determine if rates of sinus disease are increased in patients with rheumatoid arthritis (RA) and whether RA treatment alters the risk of sinus disease.
METHODS
As part of a longitudinal study of rheumatic disease outcomes, 7,243 patients with RA, 1,667 with osteoarthritis (OA), and 447 with fibromyalgia (FM) were evaluated for important sinus problems in 2003. We defined an important sinus problem as one that required a physician visit.
RESULTS
The lifetime prevalence of sinus disorders among all patients was 42.9%. During the previous 6 months 22.3% of patients with RA, 23.9% with OA, and 25.1% with FM visited a physician for a sinus problem and 22.4%, 23.9%, and 25.1% , respectively, received a prescription medication for a sinus problem. After adjustment for age and sex, the rate of physician visits for a sinus problem was significantly lower for patients with RA (22.1%) compared to patients with OA (24.8%). The strongest predictor of sinus problems among all patients was a history of allergy or asthma. Sinus problems were more common among users of etanercept: odds ratio (OR) 1.2; 95% confidence interval (CI): 1.0-1.4 univariably, and OR 1.2; 95% CI: 1.0-1.4 multivariably. Sulfasalazine (OR 0.7; 95% CI: 0.5-0.9) and leflunomide (OR 0.8; 95% CI: 0.7-1.0) had a protective effect on sinus problems.
CONCLUSIONS
Sinus problems are decreased in patients with RA compared to OA and FM. Slight protective effects on sinus problems are noted with sulfasalazine and leflunomide, and a slight increase in risk of sinus problems is noted with etanercept.