Miller Anne, Doll Helen, David Joel, Wass John
Department of Rheumatology, Nuffield Orthopaedic Centre, Windmill Road, Headington, Oxford OX3 7LD, UK.
Eur J Endocrinol. 2008 May;158(5):587-93. doi: 10.1530/EJE-07-0838.
To provide rheumatological assessment of patients with long-standing acromegaly and investigate the impact of musculoskeletal disease on quality of life.
Cross-sectional observational study.
Fifty-eight patients diagnosed with acromegaly at least 5 years previously were interviewed and examined by a rheumatologist. Each patient completed the short form-36 (SF-36), arthritis impact measurement scales 2 (AIMS2) and acromegaly quality of life questionnaires (AcroQol).
Fifty-two out of 58 (90%) reported musculoskeletal pain, with 29 (50%) reporting neck pain. Hip osteoarthritis was present in 49 (84%) and knee osteoarthritis in 20 (34%). Half the patients (52%) reported sleep disturbance, but only 2 (3.5%) had fibromyalgia. Ten (17.2%) had previously undergone carpal tunnel decompression. Fifty-one (88%) patients had consulted their general practioner and 31 (54%) complementary therapists. SF-36, AIMS2 and AcroQol scores were lower in patients with musculoskeletal pain.
This study of musculoskeletal problems in patients with acromegaly reports systematic rheumatological examination, use of medical services and quality of life scores. Musculoskeletal problems should be routinely addressed in acromegaly by both endocrinologist and rheumatologist and a multidisciplinary approach taken to management.
对长期患肢端肥大症的患者进行风湿病学评估,并调查肌肉骨骼疾病对生活质量的影响。
横断面观察性研究。
对58例至少在5年前被诊断为肢端肥大症的患者进行访谈,并由风湿病学家进行检查。每位患者完成了简短健康调查问卷(SF - 36)、关节炎影响测量量表2(AIMS2)和肢端肥大症生活质量问卷(AcroQol)。
58例患者中有52例(90%)报告有肌肉骨骼疼痛,其中29例(50%)报告有颈部疼痛。49例(84%)存在髋骨关节炎,20例(34%)存在膝骨关节炎。一半患者(52%)报告有睡眠障碍,但只有2例(3.5%)患有纤维肌痛。10例(17.2%)曾接受过腕管减压术。51例(88%)患者咨询过他们的全科医生,31例(54%)咨询过辅助治疗师。有肌肉骨骼疼痛的患者的SF - 36、AIMS2和AcroQol评分较低。
这项关于肢端肥大症患者肌肉骨骼问题的研究报告了系统的风湿病学检查、医疗服务的使用情况和生活质量评分。内分泌科医生和风湿病学家在肢端肥大症患者中应常规处理肌肉骨骼问题,并采取多学科方法进行管理。