Duarte-Salazar C, Guzmán-Vázquez S, Soto-Molina H, Cháidez-Rosales P, Ilizaliturri-Sánchez V, Nieves-Silva J, Valero-González F, Aguilera-Zepeda J M
Department of Rheumatology, Instituto Nacional de Rehabilitación, Mexico City. caro20@ prodigy.net.mx
Clin Exp Rheumatol. 2007 Nov-Dec;25(6):922-7.
Our aim was to determine the disability impact on quality of life (QOL) in Mexican adults with juvenile idiopathic arthritis polyarticular course (JIAPA) and juvenile ankylosing spondylitis (JAS).
A cross-sectional study was performed on 32 adult patients with juvenile idiopathic arthritis. Functional outcome was evaluated using Global Functional Status (GFS) according to American College of Rheumatology (ACR) and Spanish Health Assessment Questionnaire-Disability Index (HAQ-DI) arthritis-specific measurements for functional disability in patients with polyarticular course and Bath Ankylosing Spondylitis Functional Index (BASFI) for those who developed JAS. Quality of life (QOL) was assessed using SF-36 and EuroQol 5D (EQ-5D). Descriptive statistics and associations among clinical, functional, and QOL measurements were examined using Spearman's correlation test. Multiple regression analysis was used to estimate predictor factors for impaired QOL. Differences between groups were evaluated by Fisher exact and Mann-Whitney U tests, and p values of <0.05 were considered statistically significant.
JIAPA and JAS had GFS III/IV in 65 and 50%, respectively. A HAQ-DI score of > 1.5 was found in 35% of JIAPA, and a BASFI score of > 5 in 92% of JAS. Patients with JIAPA and JAS reported lower scores for all physical domains and for mental domains (physical role, social functioning, and emotional role) compared with Mexican population scores (p < 0.005). Health status between both groups studied does not show significant differences (p > 0.05). EQ-5D showed impairment in all five dimensions for both groups studied. Multiple regression analysis showed that GFS was the only variable that affects QOL assessed by SF36.
In our study population, JIAPA and JAS exhibited a great disability impact on QOL and poor functional outcome during the patients' adult life. GFS has a significant impact on quality of life.
我们的目的是确定青少年特发性关节炎多关节型（JIAPA）和青少年强直性脊柱炎（JAS）对墨西哥成年患者生活质量（QOL）的残疾影响。
对32例青少年特发性关节炎成年患者进行了一项横断面研究。根据美国风湿病学会（ACR）的全球功能状态（GFS）以及针对多关节型患者功能残疾的西班牙健康评估问卷 - 残疾指数（HAQ - DI）关节炎特异性测量方法，和针对患JAS患者的巴斯强直性脊柱炎功能指数（BASFI），评估功能结局。使用SF - 36和欧洲五维健康量表（EQ - 5D）评估生活质量（QOL）。使用Spearman相关检验检查临床、功能和QOL测量之间的描述性统计和关联。使用多元回归分析估计生活质量受损的预测因素。通过Fisher精确检验和Mann - Whitney U检验评估组间差异，p值<0.05被认为具有统计学意义。
JIAPA和JAS患者分别有65%和50%的GFS为III/IV级。35%的JIAPA患者HAQ - DI得分>1.5，92%的JAS患者BASFI得分>5。与墨西哥人群得分相比，JIAPA和JAS患者在所有身体领域以及心理领域（身体角色、社会功能和情感角色）的得分较低（p < 0.005）。所研究的两组之间的健康状况没有显著差异（p > 0.05）。EQ - 5D显示所研究的两组在所有五个维度上均有损害。多元回归分析表明，GFS是影响通过SF36评估的生活质量的唯一变量。
在我们的研究人群中，JIAPA和JAS在患者成年期对生活质量表现出极大的残疾影响且功能结局较差。GFS对生活质量有显著影响。
