全国多中心类风湿关节炎患者残疾及功能受限情况的调查
A multicenter study of deformity and disability in rheumatoid arthritis patients in China
查看参考文献16篇
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文摘
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目的了解类风湿关节炎(RA)患者的残疾及功能受限情况,分析RA导致残疾及功能受限的影响因素。方法应用问卷方式回顾性调查340例RA患者的残疾情况,应用健康评定量表残疾指数(HAQ-DI)评价患者功能受限情况。采用SPSS 13.0软件对残疾及HAQ-DI的影响因素进行单因素及多因素Logistic多元回归分析。结果①根据3种不同的标准,RA患者中残疾的发生率分别为50.3%(171/340)、36.8%(125/340)及18.8%(64/340),且均随病程的延长而增加。最常见的受累关节依次为腕关节(111/340,32.6%)、近端指间关节(82/340,24.1%)及肘关节(69/340,20.3%)。对影响残疾的因素进行Logistic多元回归分析,结果显示女性[比值比(0R)=5.179,95%可信区间(CI):1.593~16.836,P=0.006]、病程较长(OR=1.104,95%CI:1.065~1.146,P=0.000)、存在关节外表现(OR=3.813,95%CI:1.814~8.011,P=0.000)及医生可视模拟评分(VAS)疾病活动评分较高(OR=1.392,95%CI:1.230~1.577,P=0.000)是RA患者发生残疾的独立危险因素(P<0.05,R~2=0.345)。②RA患者中68.5%(233/340)存在不同程度的功能受限,其中31:3%(120/340)存在轻度功能受限,19.7%(67/340)中度功能受限,13.5%(46/340)重度功能受限。Logistic多元回归分析结果提示年龄较大(OR=1.028,95%CI:1.012~1.046,P=0.001)、医生VAS疾病活动评分较高(OR=1.603,95%CI:1.311~1.958,P=0.000)及从未规律应用过改善病情抗风湿药(DMARDs)(OR=1.721,95%CI:1.054~2.809,P=0.030)是导致患者功能受限的独立危险因素(P<0.05,R~2=0.384)。结论RA患者残疾及功能受限发生率高,且随病程延长而增加。高龄、女性、病程较长、存在关节外表现、医生疾病活动VAS评分较高及从未规律应用过DMARDs是导致RA患者残疾和(或)功能受限的独立危险因素。 |
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其他语种文摘
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Objective To describe the condition of deformity and disability in rheumatoid arthritis patients in China, and to analyze the factors that may affect deformity and disability. Methods Data were obtained from a cross-section survey of 340 patients with rheumatoid arthritis (RA), selected from Department of Rheumatology in 21 general hospitals across China. Demographic data, clinical data and Stanford health assessment questionnaire disability index (HAQ-DI) scores were collected. Univariate analysis and Logistic multiple regression were performed to determine independent prognostic factors of deformity and disability. Results ① Occurrence of deformity differed by three different standards [50.3% (171/340), 36.8% (125/340) and 18.8%(64/340) respectively], and increased with the disease course in rheumatoid arthritis patients. The most common joints involved were wrist (111/340, 32.6%),proximal interphalangeal joint (82/340, 24.1%) and elbow (69/340,20.3%). Multiple regression analysis showed that female gender (OR=5.179, 95%CI: 1.593-16.836, P=0.006), long disease course (OR=1.104, 95%CI: 1.065-1.146, P=0.000), presence of extra-articular manifestations (OR=3.813, 95%CI: 1.814-8.011, P=0.000) and high physician VAS disease activity score (OR=1.392, 95%CI: 1.230-1.577, P=0.000) were independent risk factors for deformity (P<0.05).② The median HAQ-DI score for rheumatoid arthritis patients was 0.500 points (interquartile range, 0 to 1.250). Ordinal Logistic regression showed that elder (OR=1.028, 95%CI: 1.012-1.046, P=0.001), higher physician VAS disease activity score (OR=1.603, 95%CI: 1.311-1.958, P=0.000) and never used disease-modifying antirheumatic drugs (DMARDs) regularly (OR=1.721, 95%CI: 1.054-2.809,P=0.030) could predict severe disability independently (P<0.05). Conclusion Rheumatoid arthritis patients are at high risk of deformity and disability. Deformity is associated with female gender, long disease course, presence of extra-articular manifestations and high physician VAS disease activity score. Disability could be predicted by elder, high physician VAS disease activity score and never used DMARDs regularly. |
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来源
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中华风湿病学杂志
,2013,17(8):526-532 【扩展库】
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关键词
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关节炎,类风湿
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残疾人
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健康调查
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地址
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1.
北京大学人民医院风湿免疫科, 100044
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北京大学人民医院消化科
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山西医科大学第二医院风湿免疫科
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包头医学院第一附属医院风湿免疫科
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中日友好医院风湿免疫科
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第四军医大学西京医院风湿免疫科
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河北医科大学第二医院风湿免疫科
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北京大学第三医院风湿免疫科
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河北医科大学第三医院风湿免疫科
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华北煤炭医学院附属开滦医院风湿免疫科
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北京大学第一医院风湿免疫科
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白求恩国际和平医院风湿免疫科
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河北省邯郸中心医院风湿免疫科
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河北省人民医院风湿免疫科
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北京大学首钢医院风湿免疫科
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广西壮族自治区人民医院风湿免疫科
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北京市顺义区医院风湿免疫科
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华中科技大学同济医学院附属同济医院风湿免疫科
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中山医科大学附属第一医院风湿免疫科
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北京医院风湿免疫科
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山东大学齐鲁医院风湿免疫科
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兰州大学第二医院风湿免疫科
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语种
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中文 |
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文献类型
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研究性论文 |
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ISSN
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1007-7480 |
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学科
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内科学 |
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文献收藏号
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CSCD:4926840
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参考文献 共
16
共1页
|
|
1.
Li R. Epidemiology of eight common rheumatic diseases in China:a large-scale cross-sectional survey in Beijing.
Rheumatology (Oxford),2012,51:721-729
|
被引
50
次
|
|
|
|
|
2.
刘栩. 类风湿关节炎患者就医及治疗现状分析.
中华风湿病学杂志,2008,12:637-639
|
被引
11
次
|
|
|
|
|
3.
栗占国. 类风湿关节炎在我国的低认知度和高致残率不容忽视.
中华医学杂志,2009,89:1873-1875
|
被引
10
次
|
|
|
|
|
4.
刘栩. 类风湿关节炎患者发病形式和临床特点的现况调查.
中日友好医院学报,2008,22:266-269
|
被引
2
次
|
|
|
|
|
5.
王秀茹. 全国多中心类风湿关节炎患者门诊用药费用的调查.
中华风湿病学杂志,2010,14:368-372
|
被引
9
次
|
|
|
|
|
6.
Bruce B. The Stanford health assessment questionnaire: a review of its history, issues, progress, and documentation.
J Rheumatol,2003,30:167-178
|
被引
7
次
|
|
|
|
|
7.
Scott D L. The links between joint damage and disability in rheumatoid arthritis.
Rheumatology,2000,39:122-132
|
被引
4
次
|
|
|
|
|
8.
Van der Heijde D M. Bian-nual radiographic assessments of hands and feet al in a three-year prospective followup of patients with early rheumatoid arthritis.
Arthritis Rheum,1992,35:26-34
|
被引
2
次
|
|
|
|
|
9.
Plant M J. Patterns of radiological progression in early rheumatoid arthritis: results of an 8 year prospective study.
J Rheumatol,1998,25:417-426
|
被引
3
次
|
|
|
|
|
10.
Wolfe F. Radiographic outcome of recent-onset rheumatoid arthritis: a 19-year study of radiographic progression.
Arthritis Rheum,1998,41:1571-1582
|
被引
5
次
|
|
|
|
|
11.
Graudal N A. Radiographic progression in rheumatoid arthritis: a long-term rospective study of 109 patients.
Arthritis Rheum,2004,41:1470-1480
|
被引
1
次
|
|
|
|
|
12.
Belt E A. Destruction and reconstruction of hand joints in rheumatoid arthritis: a 20 year follow up study.
J Rheumatol,1998,25:459-461
|
被引
1
次
|
|
|
|
|
13.
Cieza A. Understanding functioning, disability, and health in rheumatoid arthritis: the basis for rehabilitation care.
Curr Opin Rheumatol,2005,17:183-189
|
被引
5
次
|
|
|
|
|
14.
Schneeburger E E. Factors associated with disability in patients with rheumatoid arthritis.
J Clin Rheumatol,2010,16:215-218
|
被引
1
次
|
|
|
|
|
15.
Wolfe F. The assessment and prediction of functional disability in rheumatoid arthritis.
J Rheumatol,1991,18:1298-1306
|
被引
2
次
|
|
|
|
|
16.
Leigh J P. Predictors of disability in a longitudinal sample of patients with rheumatoid arthritis.
Ann Rheum Dis,1992,51:581-587
|
被引
1
次
|
|
|
|
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