Speyer Renée, Speyer Irene, Heijnen Mariëlle A M
Department of O.R.L. and Head and Neck Surgery, University Hospital Maastricht, Maastricht, The Netherlands.
J Voice. 2008 Mar;22(2):232-7. doi: 10.1016/j.jvoice.2006.08.015. Epub 2006 Oct 30.
Laryngeal involvement in rheumatoid arthritis is not uncommon and may include cricoarytenoid arthritis or vocal fold lesions such as vocal fold rheumatoid nodules or bamboo nodes. Dysphonia or voicing problems can be the result of such laryngeal involvement. This cohort study investigates the prevalence and the relative risk of dysphonia when suffering from rheumatoid arthritis compared to that of healthy subjects. One hundred and sixty-six subjects with rheumatic arthritis and 148 healthy control subjects completed two quality-of-life questionnaires: the Voice Handicap Index and a three-item outcome scale. Both instruments measure the quality of the voice itself and the extent of impairment resulting from dysphonia as experienced by the patient in social and occupational settings. Patients proved to have statistically significant higher prevalence and relative risk of dysphonia. Depending on the questionnaire being used, prevalence data of dysphonia in patients varied between 12% and 27%, whereas the healthy subjects showed prevalence data varying from about 3% to 8%. A patient's relative risk varied from about 3 to 4 when compared to healthy subjects. Patients suffering from rheumatoid arthritis have a clearly higher risk of dysphonia compared to healthy subjects.
类风湿性关节炎累及喉部并不罕见，可能包括环杓关节炎或声带病变，如声带类风湿结节或竹节样结节。发音障碍或发声问题可能是这种喉部受累的结果。这项队列研究调查了与健康受试者相比，类风湿性关节炎患者发音障碍的患病率和相对风险。166名类风湿性关节炎患者和148名健康对照受试者完成了两份生活质量问卷：嗓音障碍指数和一个三项结果量表。这两种工具都测量嗓音本身的质量以及患者在社交和职业环境中所经历的由发音障碍导致的损害程度。结果证明，患者发音障碍的患病率和相对风险在统计学上显著更高。根据所使用的问卷不同，患者发音障碍的患病率数据在12%至27%之间变化，而健康受试者的患病率数据约为3%至8%。与健康受试者相比，患者的相对风险约为3至4。与健康受试者相比，类风湿性关节炎患者出现发音障碍的风险明显更高。
