Heinert J, Iking-Konert C, Blumenroth M, Sander O, Richter J, Schneider M
Geschäftsstelle des Rheumzentrums Rhein-Ruhr e.V., Universitätsklinikum Düsseldorf, Deutschland.
Z Rheumatol. 2010 Oct;69(8):743-8. doi: 10.1007/s00393-010-0653-x.
Current evidence-based guidelines for patients with rheumatoid arthritis (RA) emphasize the need for early diagnosis and treatment with disease-modifying antirheumatic drugs. However, these recommendations have not been implemented universally in Germany. This prompted the German Cooperative Rheumatology Group Rhine-Ruhr to devise a screening programme for inflammatory rheumatic diseases (IRD) using a specially equipped bus, which was sent on a 5-week tour of a series on local towns. Visitors were asked to fill out a questionnaire (RheumaCheck) and to undergo a blood test for rheumatoid factor and anti-mutated citrullinated vimentin antibodies. In the case of positive test results or on request due to symptoms, visitors could undergo targeted examination on the bus by a rheumatologist. Of the 2691 people who visited the bus (73% females, average age 62 years), 1330 consulted the rheumatologist. IRD was suspected in 319 attendees and confirmed in 104 of 172 screening participants, who went on to attend a rheumatological practice. RA was diagnosed in a total of 54 cases (2.1% of all visitors).
目前针对类风湿性关节炎(RA)患者的循证指南强调早期诊断以及使用改善病情抗风湿药物进行治疗的必要性。然而,这些建议在德国并未得到普遍实施。这促使德国莱茵-鲁尔风湿病协作组设计了一项针对炎性风湿性疾病(IRD)的筛查项目,该项目使用一辆特别装备的巴士,在当地一系列城镇进行了为期5周的巡回筛查。访客们被要求填写一份问卷(类风湿检查),并接受类风湿因子和抗突变瓜氨酸波形蛋白抗体的血液检测。如果检测结果呈阳性,或者因出现症状而提出要求,访客可在巴士上接受风湿病专家的针对性检查。在参观巴士的2691人中(73%为女性,平均年龄62岁),有1330人咨询了风湿病专家。319名参与者被怀疑患有IRD,在172名接受筛查并随后前往风湿病诊所就诊的参与者中,有104人被确诊。总共诊断出54例RA(占所有访客的2.1%)。