类风湿关节炎并发症和合并症|bob体育在线日常健康

Rheumatoid arthritis, which affects up to three times as many women as men, according to an article published in September 2017 in the journalRheumatology International，也可能引起非关节特异性症状，包括fever，减肥和疲劳。

不加治疗，RAcan lead to a number of complications or comorbidities (co-occurring conditions) throughout the body, notes the Centers for Disease Control and Prevention (CDC).

These complications and conditions may be more fatal to患有RA的人than those without.In fact,患有RA的人are nearlytwice as likely to succumb to health problems根据2018年3月发表在《杂志》上的一项研究Arthritis Care and Research。

Rheumatoid Arthritis and Heart Disease Risk

People with RA often suffer from one or more additional conditions. Some of these comorbid conditions may be unrelated to RA, like certain cancers, but in other cases they may be directly or indirectly caused by RA,RA treatment，或RA结果 - 例如，迁移率和功能障碍的降低。

The most common and well-documented RA comorbidity is cardiovascular disease, in particular ischemic heart disease, in which there's a reduced blood supply in the heart. Peoplewith heart diseaseare nearly twice as likely to also have RA compared with those who don't have heart issues, according to the CDC.

Rheumatoid arthritis is also associated with several specific cardiovascular issues, including heart attack, stroke,congestive heart failure，，，，peripheral vascular disease, and心房颤动。

Research published in March 2015 in the journalNature Reviews Rheumatologyfound that people with RA are more likely to have动脉粥样硬化(buildup of fat, cholesterol, and plaque on blood vessel walls), and they develop it at a faster rate than the general population.

People with临床前RA(a precursor condition to RA) aren't safe from heart issues either. One study found that people with preclinical RA have a 24 percent increased risk of having a cardiovascular event over a 10-year period.

What's more,患有RA的人experience more severe acute coronary syndrome (ACS)- 心脏病发作，不稳定心绞痛，，，，and other symptoms associated with sudden reduced blood flow to the heart — than the general population. A cohort study published in January 2018 in the杂志 American Heart Association发现患有RA的人的1.3倍心力衰竭的风险compared with people without the disease.

The increased risk for ACS begins early in RA, too — a study published in July 2017 in the风湿性疾病上发现人们新diagnosed with RA与普通人群相比，ACS风险增加约40％。

有关的：类风湿关节炎和您：RA可以对身体的各个部位做什么

And those RA patients who do survive ACS have a 30 percent increased risk of ACS recurrence and increased risk of death compared with the general population, according to a study published in December 2017 in the journal风湿性疾病上。

But treatment withRA药物scalled disease-modifying antirheumatic drugs (dmards）may improve the early stages of heart disease, according to an October 2020 study in the same journal.

For these reasons, it is important for people with RA to assess their cardiovascular disease risk factors, such ashigh blood pressure，，，，diabetes，吸烟，并减少它们。

Other Health Conditions Related to Rheumatoid Arthritis

People with RA have an increased risk of infections that may be related to the immune system dysfunction associated with RA, per the Arthritis Foundation,

or to certain drugs that are used to treat the condition, according to an article published in July 2017 in the journalCurrent Opinion in Rheumatology。

这些药物包括corticosteroids，，，，which reduce immune system activity and are the strongest contributors to serious infections in RA patients, according to a June 2019 study published in journalRMD Open。Researchers found that people with RA had a 70 percent increased risk of serious infections compared with those with non-inflammatoryrheumaticand musculoskeletal diseases — but that increased risk drops to 30 percent after controlling for corticosteroid use.

Infections account for about one-quarter of all RA-related deaths, according to the Johns Hopkins Arthritis Center.

On the flip side, research first published in February 2015 in风湿性疾病上suggested that recentgastrointestinaland尿路感染可以通过改变微生物组（身体的微生物群落）来降低一个人发展RA的风险。

Malignancies associated with the lymphatic system, such asleukemiaandmultiple myeloma，，，，are also common in people with RA.

Additionally, RA affects the lungs and can causeRA-related lung disease。It's estimated that 1 in 10 people with RA will develop interstitial lung disease, according to the Arthritis Foundation.

This disease accounts for 10 to 20 percent of all RA deaths.

有关的：患有类风湿关节炎时保护肺部健康

Research has also found that people with asthma have 1.74 times the odds of people without asthma to have RA, according to a study published in the January–February 2018 issue ofJournal of Allergy and Clinical Immunology: In Practice。

Rheumatoid Arthritis Complications

并发症是引起的健康问题a condition or its treatment. The risk of complications from RA increases over time or when treatment is inadequate.

Over time, RA can cause more than just pain and inflammation in the joints — it can actually变形的关节，，，，making it difficult for people to perform normal daily activities.

RA会导致身体其他部位发炎，包括：

血管，称为类风湿病血管炎and can cause problems with the skin, nerves, heart, and brain
Lungs，，，，resulting in rheumatoidlung disease or other conditions，例如胸膜炎（肺组织的肿胀和疤痕）或肺结节
眼睛，，，，causingSjögren's syndrome，会干扰眼泪和唾液产生；和巩膜炎，以眼部发红和疼痛为特征
Heart, particularly the outer lining of the heart (pericarditis）和心肌（myocarditis）
手腕，引起腕管综合症，，，，in which pressure on the nerves of the hand results innumbness，刺痛和用手和手指的困难

还可能发生许多其他并发症，包括：

Peripheralneuropathy，神经功能障碍会导致神经疼痛，麻木和刺痛，尤其是在手和脚上
Muscle weakness
贫血，，，，a decreased red blood cell count that increases fatigue and weakness
Various skin conditions, such as blisters,皮疹，，，，溃疡，皮肤下的肿块
骨质疏松症，，，，or low bone density
脊柱损伤（颈部骨骼因炎症而受损时）
牙周（口香糖）疾病，，，，though some research suggests this disease precedes RA, and other research suggests some cases of RA may be caused by the same bacteria behind gum disease.
Kidney impairment caused byRA药物
脾脏的扩大（Felty综合征）
Pregnancy complications，，，，such as increased risk of premature delivery

与类风湿关节炎有关的心理健康和认知问题

Mental health conditionslike焦虑，，，，depression，，，，andbipolar disorderare not uncommon among people with arthritis, RA included.

For example, in a study published in September 2018 in theInternational Journal of Geriatric Psychiatry，研究人员发现，患有轻微抑郁症的50岁以上的成年人中有55％也患有关节炎。老年关节炎患者的这些比率跃升至62.9％和67.8％experiencing moderate and severe depression，分别。

Research presented at the June 2019 Annual European Congress of Rheumatology conference showed a similarlink between arthritis and mental health issues。In one study, researchers found that 10 percent of patients withrheumaticand musculoskeletal diseases surveyed had suicidal thoughts. Another study found that 25 percent of patients with RA or adult juvenile idiopathic arthritis experienced anxiety or depression.

Study participants also noted markedsleeping issues due to pain。

Researchers have also investigated the link between mental health issues and RA, specifically. A study published in July 2018 inArthritis Care & Researchfound that the incidence of depression, anxiety, andbipolar disorderwas higher in people with RA than those without RA by 45 percent, 25 percent, and 20 percent, respectively.

还有一些证据表明RA increases the risk of dementia。People with RA may have a 61 percent increased risk of失智compared with the general population, according to a review published in January 2016 in the journalNeurology India。

Another study, published in November 2017 in the journal毒理学和应用药理学，表明通常使用称为疾病改良抗风湿药的RA药物可能在痴呆症的发展中起作用。

然而，生物学或靶向合成dmards根据2020年美国风湿病学院虚拟年会上提出的研究，与常规DMARD相比，可能会使痴呆症的风险降低17％。

More research is needed, however, as other studies have shown conflicting results, including a decreased risk ofAlzheimer’s diseasefor RA patients (dementia is asymptom of Alzheimer's disease），，，，according to a study published in October 2017 inScientific Reports，，，，

and a reduced risk of dementia for patients using DMARDs, per an article published in November 2017 inAlzheimer's & Dementia: Translational Research & Clinical Interventions。

类风湿关节炎会引起癌症吗？

众所周知有RA的人有一个淋巴瘤的风险增加(cancer of the lymph nodes), particularly non-Hodgkin淋巴瘤。The overall incidence of lymphomas among people with RA is almost twice as high as in the general population, research shows.

Past studies have suggested that newer versions of DMARDs, called biologic DMARDs, may be partly to blame. But a large study first published in August 2017 in the journal风湿性疾病上showed thatRA treatment doesn't affect lymphoma risk。

A Swedish cohort study published in February 2021 in the journalRheumatologyfound that biologic DMARDs do not further increase lymphoma risk in RA patients. In fact, the drugs may actually reduce "excess lymphoma risk," the researchers note.

As is the case with many other RA comorbidities and complications, the increased淋巴瘤riskis likely the result of uncontrolled RA inflammation, the research suggests.

Editorial Sources and Fact-Checking

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