Молодежный инновационный вестник

2415-7805

Федеральное государственное бюджетное образовательное учреждение высшего образования "Воронежский государственный медицинский университет имени Н.Н. Бурденко" Министерства здравоохранения Российской Федерации

8261

Unclassified

ASSESSMENT OF THE PREVALENCE OF MAIN AND CONCOMITANT DISEASES AMONG RHEUMATOLOGICAL PATIENTS

Petrikhina

Olga Nikolaevna

petrikhina03@mail.ruhttps://orcid.org/0000-0002-0745-5492

Voronezh State Medical University named after N. N. Burdenko

20042023

12S2113115

09022023

20022023

2023

Relevance. Currently, rheumatic diseases (RD) are the most common pathologies in practical medicine. They are one of the frequent causes of a persistent decrease in working capacity, the development of disability. Because of this, the number of cases of patients visiting a doctor is steadily growing. Therefore, the study of the prevalence of rheumatic diseases is of no small importance in their diagnosis and treatment. Purpose: to determine and evaluate the prevalence of the main and concomitant nosological forms of rheumatic diseases in patients of different age categories. Materials and methods: The study involved 408 patients who were treated at the VUZ VO VGKB No. 20 on the basis of the rheumatology department from February 2022 to January 2023. As a result of the work, all patients were divided into two groups by gender: women and men. Then, in each group, based on age, 6 categories are allocated. They calculated the percentage of patients with the same underlying rheumatic disease, and also identified their comorbidities. Results: The number of women of the total number of patients was 61.76%, men - 38.24%. In 12 women aged 20-30 years (the first age category), rheumatoid arthritis is diagnosed as the main diagnosis, which is accompanied in 2.941% of cases by type 2 diabetes mellitus, hypertension (AH) grade 2, risk 4 and chronic bronchitis. Men of this age were not treated. Conclusion: When examining rheumatological patients, a doctor of any specialty needs to know that rheumatoid arthritis, systemic scleroderma and SLE are most common among women, rheumatoid arthritis, psoriatic arthritis and primary gout among men. Among comorbidities, the leading place is occupied by hypertension of varying degrees and risk, coronary artery disease, as well as chronic renal failure, chronic pyelonephritis, osteoporosis, bone fractures, and type 2 diabetes mellitus.

systemic inflammatory diseasespatientsrheumatic diseasesprevalence of diseasescomorbidities

системные воспалительные заболеванияпациентыревматические болезнираспространённость заболеванийсопутствующие патологии

Relevance. Currently, rheumatic diseases (RD) are the most common pathologies in practical medicine, since the key link in the pathogenesis of these diseases is chronic autoimmune inflammation of the connective tissue. The variety of clinical manifestations of RD is associated with the presence of connective tissue elements in almost all organs and systems of the human body [1]. They are one of the frequent causes of a persistent decrease in working capacity, the development of disability. Because of this, the number of cases of patients seeking medical help is steadily growing. Therefore, the study of the prevalence of rheumatic diseases is of no small importance in their diagnosis and treatment. Purpose: to determine and evaluate the prevalence of the main and concomitant nosological forms of rheumatic diseases in patients of different age categories. Materials and methods. This study is based on a comparative analysis of case histories. The study involved 408 patients who were treated at the VUZ VO VGKB No. 20 on the basis of the rheumatology department from February 2022 to January 2023. As a result of the work, all patients were divided into two groups by gender: women and men. Then, in each group, based on age, 6 categories are allocated. They calculated the percentage of patients with the same underlying rheumatic disease, and also identified their comorbidities. For registration, data processing and statistical analysis, charts were built using the Microsoft Office Excel 2016 and Microsoft Office Word 2016 software package, in which the main matching criteria were used: gender, age, main diagnosis, concomitant diagnosis. The outcome of the study was to determine and assess the prevalence of various nosological forms of rheumatic diseases, as the main and concomitant pathologies in patients of different age categories. Results. The number of women of the total number of patients was 61.76%, men - 38.24%. In 12 women aged 20-30 years (the first age category), rheumatoid arthritis is diagnosed as the main diagnosis, which is accompanied in 2.941% of cases by type 2 diabetes mellitus, hypertension (AH) grade 2, risk 4 and chronic bronchitis. Men of this age were not treated. Among 24 (5.882%) women of the second age category (30-40 years), the first half of the patients (2.941%) have chronic systemic lupus erythematosus, accompanied by osteoporosis, a pathological fracture of the 7th rib, 5th metatarsal bone of the left foot and medication Itsenko-Cushing's syndrome. The second half has rheumatoid arthritis, against which arrhythmic syndrome, GB grade 2, risk 4, impaired glucose tolerance, chronic gastritis are diagnosed. Chronic gouty nephropathy, chronic renal failure (CRF) and HD 2, risk 3 occur in 12 (2.941%) men of this age as comorbidities, the main diagnosis is gout, chronic gouty arthritis. Rheumatoid arthritis in 36 out of 48 men aged 40-50 years (third age category) is accompanied in 8.823% of cases by bilateral gonarthrosis of the 2nd degree, synovitis, coxitis, GB of the 3rd degree, risk 3. The rest of the male patients (12 people - 2.941%) have psoriatic arthritis of the polyarticular variant is diagnosed in conjunction with widespread psoriasis vulgaris of smooth skin and scalp. Women of this age were not treated. The number of patients in the fourth age category (50-60 years) among men and women is the same number - 48 people (11.764%). But among the patients, in most cases, the most common pathology is rheumatoid arthritis (36 people - 8.823%), accompanied by combined flat feet, osteopenia, dorsopathy, widespread osteochondrosis and GB grade 2, risk 3. In 12 (2.941%) of the rest, GB 2 is diagnosed, risk 3 H2A, FC1 against the background of systemic scleroderma. And men of the same age CPB2, CKD0, gouty nephropathy most often accompany gout and subacute gouty arthritis (in 5.882% of cases). The same percentage of prevalence falls on rheumatic and psoriatic arthritis of the polyarticular variant, as the main diseases (2.941% each). In rheumatoid arthritis, synovitis and pain syndrome are diagnosed in men, and in psoriatic arthritis, in addition to dactylitis of the left hand, skin rashes (psoriasis vulgaris), and pathologies of the urinary system (CPB2, CRF), as well as GB 3 degrees, the risk of cardiovascular complications are diagnosed 4. At the age of 60-70 years, most of all women applied for medical help - 120 people (29.41%). Most often, they have grade 2 hypertension, risk 3, chronic pyelonephritis, secondary osteoarthritis, CRF0, type 2 diabetes, accompanying rheumatoid arthritis in 36 (8.823%) patients. 24 (5.882%) women with systemic lupus erythematosus were diagnosed with hypertension 3, risk 3 H0, postmenopausal osteoporosis with a pathological fracture of the neck of the right femur, uterine myoma, cysts of both kidneys. The same number of patients with systemic scleroderma have coronary artery disease (arrhythmic variant), paroxysmal atrial fibrillation, hypertension 2, risk 3 H1. Bilateral gonarthrosis of the 2nd degree with synovitis of the left knee joint, bilateral osteoarthritis of the knees and ankylosing spondylitis as the main diseases account for the same percentage of prevalence among women (2.941% for each); differ only in concomitant nosologies: grade 2 GB, risk 2, impaired glucose tolerance, chronic pyelonephritis with ankylosing spondylitis, GB 1, H0 risk with bilateral gonarthrosis and grade 2 GB, risk 2 with bilateral osteoarthritis of the knees. There are much fewer men of the same age who underwent treatment - only 36 people (8.823%). 5.882% (24 people) percent account for the number of patients suffering from rheumatoid arthritis, which is accompanied by stage 2 hypertension, risk 1. Of the remaining 12 patients, the prevalence of dactylitis of the left hand, palmar fasciitis, psoriasis vulgaris, coronary artery disease, grade 2 hypertension, risk 4, on the background of psoriatic arthritis. In the latest, sixth age category from 70 to 80 years, 24 (5.882%) out of 48 (11.764%) women with rheumatoid arthritis have grade 2 hypertension, risk 3 H1 and bronchial asthma. And the remaining half of patients with osteoarthritis and bilateral gonarthrosis, in addition to hypertension, have varicose veins, coronary artery disease (stable angina pectoris), and diffuse cardiosclerosis, type 2 diabetes mellitus. In 12 (2.941%) men with rheumatoid arthritis, hypertension 3, risk 4 H2A, FC2 and COPD were diagnosed in all cases. Discussion. During the study, it was found that rheumatoid arthritis is widespread among all patients, regardless of gender. But in men, psoriatic arthritis and primary gout are not the last place, and in women - systemic scleroderma and systemic lupus erythematosus (SLE). There is also a high incidence of various pathologies of the cardiovascular system, as concomitant diseases: hypertension, coronary artery disease. GB is a universal nosology, which is diagnosed in all age categories, except for the first one, as an additional nosology. It is worth noting that among the comorbidities, diseases of the urinary system (CRF, chronic pyelonephritis), impaired glucose tolerance, type 2 diabetes mellitus, as well as lesions of the musculoskeletal system (osteoporosis, coxitis, bursitis, bone fractures, etc.) Conclusion. Immunoinflammatory rheumatic diseases (RD) are characterized by a chronic progressive course with damage to many body systems [2]. When examining rheumatological patients, a doctor of any specialty needs to know that rheumatoid arthritis, systemic scleroderma and SLE are most common among women, rheumatoid arthritis, psoriatic arthritis and primary gout among men. Among comorbidities, the leading place is occupied by hypertension of varying degrees and risk, coronary artery disease, as well as chronic renal failure, chronic pyelonephritis, osteoporosis, bone fractures, and type 2 diabetes mellitus. Timely diagnosis of these nosologies facilitates the diagnosis and the choice of the correct treatment tactics.

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