缓解期类风湿关节炎患者的功能残疾与放射学损伤及疾病活动度的关系

Functional disability in relation to radiological damage and disease activity in patients with rheumatoid arthritis in remission.

作者信息

Molenaar Esmeralda T H, Voskuyl Alexandre E, Dijkmans Ben A C

机构信息

Department of Rheumatology, Vrije Universiteit Medical Center, Amsterdam, The Netherlands.

出版信息

J Rheumatol. 2002 Feb;29(2):267-70.

PMID:11842821

Abstract

OBJECTIVE

To investigate the relationship between functional disability, disease activity and radiological damage in patients with rheumatoid arthritis (RA) in remission.

METHODS

One hundred and eighty-six patients with RA in remission or with low disease activity were studied. The following variables were assessed at one time point: joint count, visual analog scale for pain, functional disability, i.e., health assessment questionnaire (HAQ) score, radiological joint damage as assessed by radiographs of hands and feet and scored according the Sharp-van der Heijde method, and presence of comorbidity. Disease activity was expressed as the disease activity score (DAS). Correlations were calculated by Spearman's rho coefficient of correlation. In addition, variables associated with the score were analyzed by logistic regression.

RESULTS

The median HAQ score was 0.25 [interquartile (IQR) range 0-0.75] and the median DAS was 1.0 (IQR 0.7-1.5). Of the 186 RA patients included, 82% were in remission according to the DAS. The median joint damage as assessed by the Sharp-van der Heijde score was 21 (IQR 9-74). Functional disability was significantly correlated with pain (rho 0.48, p < 0.001), disease activity (rho 0.42; p < 0.001), disease duration (rho 0.39; p < 0.001), radiographic joint damage (rho 0.37; p < 0.001), and age (rho 0.19; p = 0.01). In a logistic regression model functional disability was independently related to presence of pain, disease activity, radiographic joint damage and disease duration in decreasing order of strength, but not to age. sex and co-morbidity.

CONCLUSION

Patients with RA who are in remission might experience minimal functional disability and radiographic joint damage. Functional disability in RA patients in remission is most strongly related to the presence of pain and in lesser extent to disease activity, radiographic joint damage, and disease duration.

摘要

目的

探讨缓解期类风湿关节炎（RA）患者功能残疾、疾病活动度与放射学损伤之间的关系。

方法

对186例缓解期或低疾病活动度的RA患者进行研究。在一个时间点评估以下变量：关节计数、疼痛视觉模拟量表、功能残疾，即健康评估问卷（HAQ）评分、通过手足X线片评估的放射学关节损伤并根据Sharp-van der Heijde方法评分，以及合并症的存在情况。疾病活动度用疾病活动评分（DAS）表示。采用Spearman等级相关系数计算相关性。此外，通过逻辑回归分析与该评分相关的变量。

结果

HAQ评分中位数为0.25[四分位数间距（IQR）范围0 - 0.75]，DAS中位数为1.0（IQR 0.7 - 1.5）。在纳入的186例RA患者中，根据DAS标准，82%处于缓解期。根据Sharp-van der Heijde评分评估的关节损伤中位数为21（IQR 9 - 74）。功能残疾与疼痛（rho 0.48，p < 0.001）、疾病活动度（rho 0.42；p < 0.001）、病程（rho 0.39；p < 0.001）、放射学关节损伤（rho 0.37；p < 0.001）和年龄（rho 0.19；p = 0.01）显著相关。在逻辑回归模型中，功能残疾与疼痛、疾病活动度、放射学关节损伤和病程独立相关，按强度递减顺序排列，但与年龄、性别和合并症无关。