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健康状况和疼痛感知:手部骨关节炎和类风湿关节炎女性患者的对比研究。

Health status and perception of pain: a comparative study between female patients with hand osteoarthritis and rheumatoid arthritis.

机构信息

Department of Rheumatology, Diakonhjemmet Hospital, Oslo, Norway.

出版信息

Scand J Rheumatol. 2009;38(5):342-8. doi: 10.1080/03009740902913496.

Abstract

OBJECTIVE

Osteoarthritis (OA) is the most frequent rheumatic joint disease and its occurrence is growing due to prolonged life expectancy and an increasing number of elderly individuals in the population. The main objective of this study was to compare the burden of disease, assessed by measures of pain and health-related quality of life (HRQoL), between female patients with hand osteoarthritis (HOA) and rheumatoid arthritis (RA).

METHODS

One hundred and ninety female HOA patients were compared with 194 female RA patients of the same age. HRQoL was measured with the Arthritis Impact Measurement 2 Scale (Aims2), the 36-item Short-Form Health Survey (SF-36) and its preference-based single index measure SF-6D, the Health Assessment Questionnaire (HAQ), the modified HAQ (MHAQ), self-efficacy scales, and visual analogue scales (VAS) for pain and fatigue. We also compared levels of fibromyalgia (FM)-like symptoms (headache, muscle pain, numbness, and concentration problems). Scores were compared by a multivariate analysis of covariance (ANCOVA), adjusted for age, number of comorbidities, and years of education. Sime's procedure was used to adjust for multiple testing.

RESULTS

RA patients had significantly lower levels of physical functioning compared to HOA patients, whereas pain measured on the Arthritis Impact Measurement Scale 2 (AIMS2) was significantly worse in HOA as compared with RA. The HOA patients also had worse scores for FM-like symptoms. SF-6D utility scores in HOA and RA were similar (0.63 and 0.64, respectively).

CONCLUSIONS

The overall impact of the disease on HRQoL was similar between RA and HOA patients, based on the SF-6D scores. Physical function was worse in RA patients, but HOA patients reported worse scores in pain measures and FM-like symptoms.

摘要

目的

骨关节炎(OA)是最常见的风湿性关节疾病,由于预期寿命延长和人口中老年人数量增加,其发病率不断上升。本研究的主要目的是比较手部骨关节炎(HOA)和类风湿关节炎(RA)女性患者的疾病负担,通过疼痛和健康相关生活质量(HRQoL)的衡量指标来评估。

方法

将 190 例女性 HOA 患者与 194 例年龄相同的女性 RA 患者进行比较。使用关节炎影响测量 2 量表(Aims2)、36 项简短健康调查(SF-36)及其偏好单指数测量 SF-6D、健康评估问卷(HAQ)、改良 HAQ(MHAQ)、自我效能量表和视觉模拟量表(VAS)来衡量 HRQoL,用于评估疼痛和疲劳。我们还比较了纤维肌痛(FM)样症状(头痛、肌肉疼痛、麻木和注意力问题)的水平。通过协方差分析(ANCOVA)对年龄、共病数量和受教育年限进行调整,对评分进行比较。使用 Sime 程序对多重测试进行调整。

结果

与 HOA 患者相比,RA 患者的身体机能水平显著降低,而 AIMS2 测量的疼痛在 HOA 中比 RA 更严重。HOA 患者的 FM 样症状评分也更差。HOA 和 RA 的 SF-6D 效用评分相似(分别为 0.63 和 0.64)。

结论

基于 SF-6D 评分,RA 和 HOA 患者的疾病对 HRQoL 的总体影响相似。RA 患者的身体机能更差,但 HOA 患者报告的疼痛测量和 FM 样症状评分更差。

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