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膝关节和髋关节的影像学骨关节炎特征:在疼痛、功能和生活质量方面的差异。

Knee and hip radiographic osteoarthritis features: differences on pain, function and quality of life.

作者信息

Pereira Duarte, Severo Milton, Santos Rui A, Barros Henrique, Branco Jaime, Lucas Raquel, Costa Lúcia, Ramos Elisabete

机构信息

Department of Clinical Epidemiology, Predictive Medicine and Public Health, University of Porto Medical School, 4200-319, Porto, Portugal.

EPI Unit, Public Health Institute, University of Porto, Porto, Portugal.

出版信息

Clin Rheumatol. 2016 Jun;35(6):1555-64. doi: 10.1007/s10067-015-3087-7. Epub 2015 Oct 7.

Abstract

The association between radiographic osteoarthritis (OA) and symptoms is inconsistent and variable according to each joint. The purpose of this study is to understand the relation between radiographic OA features, pain, function and quality of life, in knee and hip joints. A cross-sectional study was performed using information from EPIPorto cohort. Data was obtained by interview using a structured questionnaire on social, demographic, behavioural and clinical data. Pain was assessed using a pain frequency score (regarding ever having knee pain, pain in the last year, in the last 6 months and in the last month). Quality of life was evaluated with Short Form 36 (SF-36) and function disability with the Lequesne knee and hip indexes. Radiographic knees and hips were classified using the Kellgren-Lawrence score (KL 0-4). Linear regression and proportional odds ratios estimated the association between radiographic features, pain, function and quality of life. In our study, symptomatic OA (KL ≥ 2 plus joint pain) was 26.0 % in knee and 7.0 % hip joints. In knee, the increase on radiographic score increased the odds to have a higher pain frequency score [1.58 (95 % CI = 1.27, 1.97)] and was associated [adjusted β (95 % CI)] with worst general health [-3.05 (-5.00, -1.09)], physical function [-4.92 (-7.03, -2.80)], role-physical [-4.10 (-8.08, -0.11)], bodily pain [-2.96 (-5.45, -0.48)] and limitations in activities of daily living [0.48 (0.08, 0.89)]. Regarding hip, no significant associations were found between the severity of radiographic lesions and these measures. Radiographic lesions in knee were associated with higher complaints, as far as pain and functional limitations are concerned, compared with hip.

摘要

影像学骨关节炎(OA)与症状之间的关联并不一致,且因关节不同而有所变化。本研究旨在了解膝关节和髋关节的影像学OA特征、疼痛、功能及生活质量之间的关系。利用EPIPorto队列研究的信息进行了一项横断面研究。通过使用关于社会、人口统计学、行为和临床数据的结构化问卷进行访谈来获取数据。使用疼痛频率评分(关于是否曾有膝关节疼痛、过去一年、过去6个月和过去一个月的疼痛情况)评估疼痛。用简短健康调查问卷(SF - 36)评估生活质量,用Lequesne膝关节和髋关节指数评估功能障碍。使用Kellgren - Lawrence评分(KL 0 - 4)对膝关节和髋关节的影像学表现进行分类。线性回归和比例优势比估计了影像学特征、疼痛、功能和生活质量之间的关联。在我们的研究中,有症状的OA(KL≥2加关节疼痛)在膝关节中占26.0%,在髋关节中占7.0%。在膝关节方面,影像学评分的增加使疼痛频率评分更高的几率增加[1.58(95%CI = 1.27,1.97)],并与较差的总体健康状况[调整后β(95%CI)为 - 3.05( - 5.00, - 1.09)]、身体功能[ - 4.92( - 7.03, - 2.80)]、角色 - 身体功能[ - 4.10( - 8.08, - 0.11)]、身体疼痛[ - 2.96( - 5.45, - 0.48)]以及日常生活活动受限[0.48(0.08, 0.89)]相关。关于髋关节,未发现影像学病变严重程度与这些指标之间存在显著关联。就疼痛和功能受限而言,与髋关节相比,膝关节的影像学病变与更多的不适主诉相关。

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