Objective: To explore the menopause status of patients with rheumatoid arthritis (RA) and clinical characteristics of perimenopausal RA patients. Methods: A cross-sectional study. Female RA patients were recruited retrospectively in the Sun Yat-Sen Memorial Hospital from August 2015 to August 2023. Clinical data were collected, including onset age, disease duration, RA disease activity indicators, functional assessment, and radiographic scores. According to menopausal status, the patients were categorized as pre-menopausal, perimenopausal and post-menopausal groups to explore their menopausal and clinical characteristics. Results: A total of 1 151 female patients were enrolled, with a mean age of (50.2±13.0) years. At enrollment, there were 470 (40.8%), 140 (12.2%) and 541 (47.0%) patients in pre-menopause, perimenopause and post-menopause status, respectively. The mean age of menopause was (49.0±4.2) years. Compared with pre-menopausal group, perimenopausal RA patients had higher disease activity indicators [clinical disease activity index (CDAI) 17 (6, 26) vs 10 (3, 19) ], higher levels of inflammation [erythrocyte sedimentation rate (ESR) 35 (21, 65) vs 26 (14, 44) mm/1h, C-reactive protein (CRP) 6.2 (3.2, 16.8) vs 3.3 (3.2, 13.6) mg/L], and a higher proportion of functional limitation [25.0%(35/140) vs 10.4%(49/470)] (all P<0.016 7); while there was no significant differences in disease activity[M(Q1, Q3)] [CDAI 17 (6, 26) vs 14 (6, 25)], levels of inflammation [ESR 35(21, 65) vs 42 (23, 72) mm/1h, CRP 6.2 (3.2, 16.8) vs 6.2 (3.3, 23.9) mg/L] and functional limitation [25.0%(35/140) vs 28.8%(156/541)] when compared with those in post-menopausal group (all P>0.016 7). In RA patients during the perimenopausal period, 49 cases (35.0%) developed RA during this period. Compared with patients with RA onset during reproductive age, patients with RA onset during the perimenopausal period had higher numbers of 28-joint tender joints [7 (2, 10) vs 4 (0, 8)], higher CDAI [20 (12, 29) vs 14 (4, 24)], and higher ESR [45 (25, 72) vs 32 (18, 56) mm/1h] (all P<0.05). Conclusion: Perimenopausal patients with RA have severe disease activity and functional limitation.
目的： 了解女性类风湿关节炎（RA）患者的绝经状态及围绝经期患者临床特征。 方法： 横断面研究。回顾性纳入2015年8月至2023年8月就诊于中山大学孙逸仙纪念医院的女性RA患者，收集其临床资料，包括发病年龄、病程、RA疾病活动、功能及放射学指标和绝经状态等。依绝经状态情况，将患者分为生育期、围绝经期和绝经后期组，分析绝经状态分布及比较3组的临床特征。 结果： 共纳入女性RA患者1 151例，年龄为（50.2±13.0）岁，入组时处于生育期患者470例（40.8%）、围绝经期140例（12.2%）和绝经后期541例（47.0%），绝经年龄为（49.0±4.2）岁。与生育期患者相比，围绝经期女性RA患者的疾病活动指标［临床疾病活动指数（CDAI）［M（Q1，Q3）］：17（6，26）比10（3，19）］、炎症水平［红细胞沉降率（ESR）：35（21，65）比26（14，44）mm/1h、C反应蛋白（CRP）：6.2（3.2，16.8）比3.3（3.2，13.6）mg/L］和功能受限的比例［25.0%（35/140）比10.4%（49/470）］均更高（均P<0.016 7）；而与绝经后期患者相比，RA疾病活动指标［CDAI：17（6，26）比14（6，25）分，ESR：35（21，65）比42（23，72）mm/1h、CRP：6.2（3.2，16.8）比6.2（3.3，23.9）mg/L］及功能受限比例［25.0%（35/140）比28.8%（156/541）］相当（均P>0.016 7）。围绝经期RA患者中，35.0%（49/140）患者RA为围绝经期发病，与生育期发病患者相比，围绝经期发病的RA患者28个压痛关节数［7（2，10）比4（0，8）个］、CDAI［20（12，29）比14（4，24）］及ESR水平［45（25，72）比32（18，56）mm/1h］均较高（均P<0.05）。 结论： 围绝经期女性RA患者的疾病活动和功能受限均较重。.