男性痛风患者发生骨侵蚀的危险因素分析

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[中图分类号] R589.7 [文献标志码]A

Risk factors for bone erosion in male patients with goutHUO Fei，AI Xiaobo，REN Wei， HAN Lin，L1 Runze（Gout Clinical Medical Center，The Afiliated Hospitalof Qingdao University，Qingdao 266o03，China）

[ABSTRACT]ObjectiveToinvestigate the risk factors associated with bone erosionin male patients with gout.Methods Atotalof297malepatientswithgoutwhopresentedfortheirinitialvisittotheGout ClinicalMedicalCenteroftheAfiliatedHos pitalof Qingdao UniversitybetweenJanuary 2020and December 2O21andunderwent musculoskeletalultrasound examinations wereretrospectivelyenroled.Basedonthepresenceorabsenceofboneerosiononmusculoskeletalultrasonography，thepatients were classified into a bone-erosion group （ ⋅n=73 ）and a non-bone-erosion group （ n=224 ）. Clinical，pathological，and ultrasono graphicalparameters werecollctedandcompared betweethetwo groups.Amultivariablelogisticregresionanalysis wasusedto identifyriskfactorsforboneerosioninmalegoutpatients，andareceiveroperatingcharacteristic（ROC）curveanalysis wasperformedtoassessthediagnosticperformanceofstatisticallysignificantfactors.ResultsSignificant diferences wereoservedbetweenthetwo groupsinage，gout duration，serumurea nitrogenlevel，serum creatininelevel，estimated glomerularfiltrationrate （eGFR），familyhistoryofgout，theproportionof patientswithfrequentgoutatacks withinthepastyear，theproportionofcolchicineuse，andthepresence，size，and numberoftophi，as wellas inthe doublecontour signandsynovial thickening（ Z= -4.626--3.361，t=-5.787，χ2=4.325-33.515，P<0.05） . The multivariable logistic regression analysis indicated that reduced eGFR，family historyofgout，frequent goutatacks withinthepastyear，presenceof doublecontour sign，andincreased tophus size were risk factors for bone erosion in male gout patients（Wald χ2=4.115-12.263，P<0.05） . The ROC curve analysis showed thatthe area under the ROC curveof tophus sizefor predicting bone erosion was O.744，with an optimal cutoff value of 0.565cm ConclusionReducedeGFR，familyhistoryof gout，frequent goutatacks withinthepastyear，presenceof doublecontoursignon ultrasonography，andincreasedtophussizearepotentialriskfactors forboneerosioninmalepatients withgout.Among these，to phus size is a key predictor of bone erosion risk.

[KEY WORDs] Gout；Arthritis，gouty；Bone erosion；Ultrasonography；Risk factors

痛风作为一种由体内嘌呤与尿酸代谢紊乱引发的炎症性关节炎，近几十年来其发病率、患病率及疾病相关死亡率呈持续上升趋势[1-4]。（剩余11306字）