Cakar Engin, Taskaynatan Mehmet Ali, Dincer Umit, Kiralp Mehmet Zeki, Durmus Oguz, Ozgül Ahmet
Department of Physical Medicine and Rehabilitation, Gülhane Military Medical Academy, Haydarpasa Training Hospital, Istanbul, Turkey.
Clin Rheumatol. 2009 Nov;28(11):1309-14. doi: 10.1007/s10067-009-1249-1. Epub 2009 Aug 16.
Ankylosing spondylitis (AS) is a systemic chronic inflammatory disease primarily affecting the axial skeleton. Work disability can be one of the major consequences of AS, and the knowledge about the burden of AS to the patient and society is not well-established yet. The objective of this study was to investigate work disability among patients with AS in the national service and to put forward the related factors and differences among disabled and nondisabled groups. A total of 121 male AS patients were included in the study. Patient demographics and duration of disease were noted, and employment status and disability were questioned. Measures of functionality, axial mobility, health-related quality of life, and depression were used. It was found that 38 patients (31.4%) continued their work lives with no change, 54 patients (44.6%) changed to a lighter job, and 29 patients (24%) were retired due to AS. Differences in age at onset of the disease, time since the diagnosis, C-reactive protein (CRP) levels, and hip involvement were statistically significant. The mean retirement age of the patients was 36 +/- 4.2 years. Frequency of hip involvement was higher in the work-disabled group. Spine was evidently affected more seriously, and CRP values were higher in the work-disabled group. Older age at onset, longer time since the diagnosis, longer diagnosis delay, and some physical impairments like decrease in spinal mobility and hip involvement may preclude AS patients from leading a productive work life.
强直性脊柱炎(AS)是一种主要影响中轴骨骼的全身性慢性炎症性疾病。工作残疾可能是AS的主要后果之一,目前对于AS给患者和社会造成的负担的认识尚不充分。本研究的目的是调查国家服务体系中AS患者的工作残疾情况,并提出残疾组和非残疾组之间的相关因素及差异。共有121名男性AS患者纳入本研究。记录患者的人口统计学特征和病程,并询问就业状况和残疾情况。采用功能、轴向活动度、健康相关生活质量和抑郁的测量指标。结果发现,38例患者(31.4%)工作生活未受影响,54例患者(44.6%)转至较轻工作岗位,29例患者(24%)因AS退休。疾病发病年龄、诊断后时间、C反应蛋白(CRP)水平和髋关节受累情况存在统计学显著差异。患者的平均退休年龄为36±4.2岁。工作残疾组髋关节受累频率更高。脊柱明显受影响更严重,工作残疾组的CRP值更高。发病年龄较大、诊断后时间较长、诊断延迟较长以及一些身体损伤如脊柱活动度降低和髋关节受累可能使AS患者无法过上有成效的工作生活。