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努力提高公众的认识可能会导致类风湿关节炎的更及时诊断。

Efforts to increase public awareness may result in more timely diagnosis of rheumatoid arthritis.

机构信息

Al Biraa Arthritis Clinic, Dubai, United Arab Emirates.

出版信息

J Clin Rheumatol. 2012 Sep;18(6):279-82. doi: 10.1097/RHU.0b013e3182676975.

Abstract

BACKGROUND

Patients with rheumatoid arthritis (RA) in the United Arab Emirates (UAE) have previously been found to have a long delay to diagnosis and low utilization of disease-modifying antirheumatic drugs (DMARDs). Over the past 5 years, support groups, awareness programs, and public campaigns have been instituted in the region.

AIM

This study aimed to assess whether such initiatives have affected the lag to diagnosis previously observed.

METHODS

Demographic, disease, and treatment data on the first 100 patients meeting American College of Rheumatology (1987) criteria for RA, presenting to our practice for the first time, were compared with similar data from 2006 on patients presenting to a different musculoskeletal clinic.

RESULTS

Subjects had a mean age of 40.2 (±11.0) years (42.2 [±12.3] years in the previous study; Student t test, P > 0.05). Rheumatoid factor was positive in 62% of subjects, whereas 73% were titer positive in the previous study (χ(2) test, P > 0.05). There was a mean reduction in lag time from symptom onset to diagnosis by 45.8%, from 14.4 (±15.6) to 7.8 (±12.1) months (Student t test, P = 0.001) between data sets. The lag to initial DMARD was also reduced by a mean of 34.9%, from 19.2 (±24) to 12.5 (±21.7) months (Student t test, P = 0.04).

CONCLUSIONS

Findings suggest that the lag to diagnosis and initiation of DMARD therapy has reduced significantly among patients with RA in the United Arab Emirates, over the past 5 years. This may be attributed to the inception of patient support groups and increasing public awareness. Larger studies are needed to substantiate this further and to address whether shorter lag times can positively influence rates of disease remission and quality of life for our patients with RA (as this was a region specific study).

摘要

背景

阿联酋(UAE)的类风湿关节炎(RA)患者此前被发现存在诊断延迟时间长和疾病修饰抗风湿药物(DMARD)利用率低的问题。在过去的 5 年中,该地区已经建立了支持团体、意识项目和公共宣传活动。

目的

本研究旨在评估这些举措是否影响了之前观察到的诊断延迟。

方法

比较了首次到我们诊所就诊的符合美国风湿病学会(1987 年)RA 标准的前 100 名患者的人口统计学、疾病和治疗数据,以及 2006 年在另一家肌肉骨骼诊所就诊的患者的类似数据。

结果

患者的平均年龄为 40.2(±11.0)岁(前一项研究中的 42.2(±12.3)岁;学生 t 检验,P>0.05)。62%的患者类风湿因子阳性,而前一项研究中 73%的患者滴度阳性(卡方检验,P>0.05)。从症状出现到诊断的平均延迟时间减少了 45.8%,从 14.4(±15.6)个月减少到 7.8(±12.1)个月(学生 t 检验,P=0.001)。从初始 DMARD 开始的延迟时间也平均减少了 34.9%,从 19.2(±24)个月减少到 12.5(±21.7)个月(学生 t 检验,P=0.04)。

结论

研究结果表明,在过去的 5 年中,阿联酋 RA 患者的诊断延迟和 DMARD 治疗开始时间显著缩短。这可能归因于患者支持团体的成立和公众意识的提高。需要进行更大规模的研究来进一步证实这一点,并探讨较短的延迟时间是否可以积极影响我们的 RA 患者的疾病缓解率和生活质量(因为这是一项特定于该地区的研究)。

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