Palferman Tom G
Department of Rheumatology, Yeovil District Hospital, Yeovil, Somerset, United Kingdom.
J Rheumatol Suppl. 2003 Aug;67:10-3.
One percent of the UK population suffers from rheumatoid arthritis (RA), with a female to male ratio of 3:1. The disease has a major influence on employment and disability rates. About 15% are classified as having serious illness, which prognostically is equivalent to 3-vessel coronary artery disease. Overall life expectancy for those with RA is reduced on average by 5 years. Financial costs are enormous. Per-patient, each year, direct and indirect costs total about 7000 pounds sterling. Costs escalate with disease severity. In a specialist rheumatology clinic, about 12% of new referrals have RA, and these patients account for more than 40% of the followup workload. The approach to management is changing, with emphasis on earlier, more aggressive intervention. This is acknowledged to improve outcome. For the severe disease, management has been revolutionized by the introduction of biologic agents. RA is managed by a multidisciplinary team, and there are active patient support groups. Advances in knowledge about genetic and immunological mechanisms of disease hold promise for further progress. Never was there a greater need for a successful alliance to deliver effective, high quality services involving government, professionals, patients, and their advocates.
英国1%的人口患有类风湿性关节炎（RA），女性与男性的患病比例为3:1。这种疾病对就业和残疾率有重大影响。约15%的患者被归类为患有严重疾病，从预后角度看，这等同于三支血管冠状动脉疾病。总体而言，RA患者的预期寿命平均缩短5年。经济成本巨大。每位患者每年的直接和间接成本总计约7000英镑。成本会随着疾病严重程度而增加。在一家专科风湿病诊所，约12%的新转诊患者患有RA，这些患者占后续工作量的40%以上。管理方法正在改变，重点是更早、更积极的干预。人们认识到这会改善治疗结果。对于严重疾病，生物制剂的引入彻底改变了治疗方式。RA由多学科团队进行管理，并且有活跃的患者支持团体。关于该疾病遗传和免疫机制的知识进展为进一步发展带来了希望。从来没有像现在这样更需要政府、专业人员、患者及其倡导者之间结成成功的联盟，以提供有效、高质量的服务。
