Zeng Qing Yu, Chen Ren, Darmawan John, Xiao Zheng Yu, Chen Su Biao, Wigley Richard, Le Chen Shun, Zhang Nai Zheng
Department of Rheumatology, the 1st Affiliated Hospital, Shantou University Medical College, 22 Xinling Road, Shantou, 515041 Guangdong, China.
Arthritis Res Ther. 2008;10(1):R17. doi: 10.1186/ar2368. Epub 2008 Jan 31.
Epidemiological studies of rheumatic diseases have been conducted during the past 20 years in China. The aim of this study was to clarify prevalence rates of common rheumatic diseases in China.
Relevant reports of population-based surveys conducted from 1980 to 2006 were retrieved. Studies using the World Health Organization-International League of Associations for Rheumatology COPCORD (Community Oriented Program for Control of Rheumatic Diseases) protocol and those that did not employ this protocol but were published in recognized journals were identified and analyzed.
Thirty-eight surveys including 241,169 adults from 25 provinces/cities were pooled for analysis. The prevalence of rheumatic complaints ranged from 11.6% to 46.4%, varying by locality, study protocol and age of the people surveyed. Prevalence of symptomatic osteoarthritis (OA) varied from 5.1% to 20.8%, with common sites of involvement being the lumbar spine, knee joint and cervical spine. Compared with rates of radiographic and symptomatic knee OA in the USA, elderly men in Beijing exhibited similar prevalence rates and elderly women exhibited a higher prevalence. The prevalence of hip OA and hand OA was much lower in Chinese than in Caucasian populations, but both kinds of OA were more common in coal miners. The prevalence of ankylosing spondylitis ranged from 0.2% to 0.54% among Han ethnic Chinese and were lower among mixed ethnic populations. The prevalence of psoriatic arthritis ranged from 0.01% to 0.1%, and that of reactive arthritis was 0.02%; undifferentiated spondyloarthropathy was identified in 0.64% to 1.2% of the individuals included in the surveys. The prevalence of rheumatoid arthritis (RA) ranged from 0.2% to 0.93%, with the highest rate being reported from a Taiwan urban area. In mainland China there were no significant differences in prevalence of RA between the northern and southern parts of China, or between different ethnic groups. The prevalence of hyperuricemia increased after the 1980s. The prevalence of gout was found to have increased in recent decades from 0.15% to 1.98%, apart from in the Taiwan aborigines, among whom the highest prevalence rate of 11.7% was recorded. The prevalence of primary Sjögren's syndrome in Beijing was 0.77% by the Copenhagen criteria and 0.33% by the San Diego criteria. The prevalence of soft tissue rheumatism was 2.5% to 5.7%. Fibromyalgia was seldom observed in China.
Rheumatic diseases are common in China. The prevalence of rheumatic complaints varied with the locality surveyed. The prevalence of OA is comparable with that in Western countries but varies in terms of joint involvement. The prevalence of ankylosing spondylitis is similar to that in Caucasians. Except in Taiwan, the prevalence of RA in China is lower than that in developed countries. The prevalence of hyperuricemia and gout increased after the 1980s, but it remains lower than that in developed countries. More studies are required to evaluate prevalence rates among minority groups in the west and northwest parts of China, and further study is needed to address fibromyalgia in China.
在过去20年里，中国开展了关于风湿性疾病的流行病学研究。本研究旨在明确中国常见风湿性疾病的患病率。
检索了1980年至2006年开展的基于人群调查的相关报告。确定并分析了采用世界卫生组织-国际风湿病联盟社区导向性风湿病控制项目（COPCORD）方案的研究以及未采用该方案但发表在知名期刊上的研究。
汇总了来自25个省/市的38项调查，涉及241,169名成年人进行分析。风湿性疾病主诉的患病率在11.6%至46.4%之间，因地区、研究方案和受调查人群年龄而异。有症状的骨关节炎（OA）患病率在5.1%至20.8%之间，常见受累部位为腰椎、膝关节和颈椎。与美国影像学确诊和有症状的膝关节OA患病率相比，北京的老年男性患病率相似，老年女性患病率更高。中国髋部OA和手部OA的患病率远低于白种人群，但这两种OA在煤矿工人中更常见。汉族人群中强直性脊柱炎的患病率在0.2%至0.54%之间，混血人群中患病率较低。银屑病关节炎的患病率在0.01%至0.1%之间，反应性关节炎的患病率为0.02%；在纳入调查的个体中，未分化脊柱关节病的患病率为0.64%至1.2%。类风湿关节炎（RA）的患病率在0.2%至0.93%之间，台湾一个城市地区报告的患病率最高。在中国大陆，RA患病率在南北地区之间或不同民族之间无显著差异。高尿酸血症的患病率在20世纪80年代后有所上升。近几十年来，痛风的患病率从0.15%上升至1.98%，但台湾原住民除外，其痛风患病率最高，为11.7%。根据哥本哈根标准，北京原发性干燥综合征的患病率为0.77%，根据圣地亚哥标准为0.33%。软组织风湿病的患病率为2.5%至5.7%。在中国，纤维肌痛很少见。
风湿性疾病在中国很常见。风湿性疾病主诉的患病率因调查地区而异。OA的患病率与西方国家相当，但在关节受累方面有所不同。强直性脊柱炎的患病率与白种人相似。除台湾外，中国RA的患病率低于发达国家。高尿酸血症和痛风的患病率在20世纪80年代后有所上升，但仍低于发达国家。需要更多研究来评估中国西部和西北部少数民族群体的患病率，还需要进一步研究来解决中国的纤维肌痛问题。
