基于"遗传—环境—免疫"类风湿关节炎高风险人群筛查及中医证型分析OA

Objective To improve preclinical rheumatoid arthritis(pre-RA)screening methods by developing a secondary screening strategy based on a"genetic-environment-immune"framework,to enhance identification accuracy of high-risk populations,and to analyze Chinese Medicine(CM)syndrome distribution.Methods Identify high-risk populations for rheumatoid arthritis(RA)through primary screening.Secondary screening confirms pre-RA patients.CM syndrome analyses were performed in high-risk groups,the distribution law and characteristics of CM syndromes were discussed.Results Out of 7 195 individuals screened,314 were identified as high-risk,and 80 were confirmed as pre-RA patients.These individuals showed abnormally elevated erythrocyte sedimentation rate(ESR,32.50±23.75 mm/h),rheumatoid factor(RF,52.63±88.17 IU/mL)anti-cyclic citrullinated antibody(Anti-CCP,52.60±88.20 U/mL).Common CM syndromes were sequenced as wind-dampness obstruction(27.7％),cold-dampness obstruction(16.9％),Gan-Shen deficiency syndrome(16.2％),Pi deficiency with dampness obstruction syndrome(13.4％),damp-heat obstruction syndrome(9.2％),blood stasis obstructing the collaterals syndrome(7.6％),phlegm-blood stasis obstruction syndrome(5.1％),and qi-blood deficiency syndrome(3.8％).The proportion of damp-heat obstruction syndrome was significantly higher in males than in females(23.0％vs.5.9％;x2=15.019,P＜0.01).The majority of CM syndromes were concentrated in the 41～60 years old groups(63.4％),followed by the≤40 years group(20.1％),while individuals aged＞60 years accounted for a smaller proportion(16.6％).Phlegm-blood stasis obstruction syndrome was mainly distributed in the 41～60 years old and＞60 years old groups(both 37.5％),with significant differences among age groups(x2=6.142,P＜0.05).Conclusions The strategy effectively identified pre-RA individuals in high-risk RA patients.Bi(obstruction)syndromes predominated inRA high-risk groups,manifesting differences in gender and age.