Department of Rehabilitation Medicine, Jan van Breemen Institute, VU University Medical Centre, Amsterdam, The Netherlands.
J Rehabil Med. 2010 Nov;42(10):916-21. doi: 10.2340/16501977-0619.
To determine the prevalence of hand and wrist symptoms and impairments, and the resulting activity limitations in relation to disease duration in patients with rheumatoid arthritis.
A cross-sectional study included 200 consecutive patients with rheumatoid arthritis in 4 categories of disease duration: 2-4, 4-6, 6-8 and ≥ 8 years. Patients were asked about the presence of various hand and wrist symptoms, and underwent a standardized physical examination. To evaluate activity limitations, patients completed the Disabilities of the Arm Shoulder and Hand questionnaire and scored their limitations on a Numerical Rating Scale (0 = no to 10 = maximum limitation).
Of all patients, 94% suffered from at least one symptom, and 67% had at least one impairment, mostly from the earliest stages onwards. The median standardized Disabilities of the Arm Shoulder and Hand score (interquartile range) was 26.7 (10.8-42.5). The mean Numerical Rating Scale score for activity limitations was 2.99 (standard deviation 2.50) in the dominant hand and 2.59 (standard deviation 2.49) in the non-dominant hand.
A high prevalence of hand and wrist symptoms and impairments is often already present after 2 years of disease duration. We recommend that physicians specifically screen for these symptoms and impairments, starting 2 years after the diagnosis of rheumatoid arthritis.
确定类风湿关节炎患者手部和腕部症状及损伤的患病率，以及与疾病持续时间相关的活动受限情况。
本研究为横断面研究，纳入了 4 组疾病持续时间（2-4 年、4-6 年、6-8 年和≥8 年）的 200 例连续类风湿关节炎患者。患者报告了各种手部和腕部症状，并接受了标准化的体格检查。为了评估活动受限情况，患者完成了《手臂、肩和手残疾问卷》，并用数字评分量表（0=无到 10=最大限制）对其限制进行评分。
所有患者中，94%至少存在一种症状，67%至少存在一种损伤，且大多从最早阶段就出现损伤。标准化的《手臂、肩和手残疾问卷》中位数（四分位间距）评分（26.7[10.8-42.5]）。活动受限的平均数字评分量表评分在优势手为 2.99（标准差 2.50），在非优势手为 2.59（标准差 2.49）。
疾病持续时间 2 年后，手部和腕部症状及损伤的高患病率通常已经存在。我们建议医生在类风湿关节炎诊断后 2 年开始专门对这些症状和损伤进行筛查。
