Institute of Rheumatology, School of Medicine, University of Belgrade, Serbia.
Clin Exp Rheumatol. 2011 Mar-Apr;29(2):337-44. Epub 2011 Apr 19.
We longitudinally studied outcomes of patients with juvenile idiopathic arthritis (JIA) using the Childhood Health Assessment Questionnaire (CHAQ) for physical disability and the Juvenile Arthritis Damage Index for articular (JADI-A) and extra-articular damage (JADI-E), and we correlated them with various disease activity variables.
Eighty-seven patients with JIA were included in the prospective follow-up study with median age 14 years (4.6-18.0), disease duration 5.2 years (2.0-18.9) and follow-up of 4.0 years (2.0-5.2). Besides JADI-A and JADI-E, and the assessment of active joints count, joints with limited mobility, ESR, CHAQ and radiographic damage of joints was also done. A correlation analysis of CHAQ and JADI with various disease activity variables was performed.
The patient's distribution of JIA subtypes were polyarticular (32), systemic onset (13), oligoarticular (31), and enthesitis related arthritis (11). After a follow-up period, 46% patients had active disease compared to 83% patients at baseline (p<0.01). The CHAQ disability index improved over baseline, while radiological damage (p<0.001) and JADI-A and JADI-E scores worsened (p<0.001). CHAQ and JADI significantly correlated with the majority of disease activity variables. CHAQ DI was significantly higher in the patients with coxitis (p<0.01) and wrist arthritis (p<0.001). The most pronounced deterioration in articular damage (JADI-A) was observed in patients with sJIA (3.69 at baseline vs. 5.69 at study endpoint).
The improvement of functional disability (CHAQ DI) was observed over the course of the disease, whereas radiological joint damage, JADI-A and JADI-E scores worsened. Children with systemic JIA, wrist arthritis, coxitis and prolonged active disease are at higher risk of progression of severe disability.
我们使用儿童健康评估问卷（CHAQ）评估身体残疾、关节 Juvenile Arthritis Damage Index（JADI-A）和关节外损伤 Juvenile Arthritis Damage Index（JADI-E），对幼年特发性关节炎（JIA）患者进行纵向研究，并将其与各种疾病活动变量相关联。
我们对 87 例 JIA 患者进行前瞻性随访研究，中位年龄 14 岁（4.6-18.0），疾病持续时间 5.2 年（2.0-18.9），随访 4.0 年（2.0-5.2）。除了 JADI-A 和 JADI-E，以及活跃关节计数、活动受限关节、ESR、CHAQ 和关节放射学损伤的评估外，还进行了各种疾病活动变量的相关性分析。
JIA 亚型患者分布为多关节炎（32%）、全身型（13%）、少关节炎（31%）和附着点炎相关关节炎（11%）。与基线相比，经过随访后，46%的患者疾病处于活动期，而 83%的患者处于活动期（p<0.01）。CHAQ 残疾指数较基线有所改善，而放射学损伤（p<0.001）和 JADI-A 和 JADI-E 评分恶化（p<0.001）。CHAQ 和 JADI 与大多数疾病活动变量显著相关。髋关节炎（p<0.01）和腕关节炎（p<0.001）患者的 CHAQ 残疾指数显著升高。sJIA 患者的关节损伤（JADI-A）最明显恶化（基线时为 3.69，研究终点时为 5.69）。
在疾病过程中观察到功能残疾（CHAQ DI）的改善，而放射学关节损伤、JADI-A 和 JADI-E 评分恶化。全身型 JIA、腕关节炎、髋关节炎和持续活动期较长的儿童发生严重残疾进展的风险更高。
