Benarous Lucas, Terrier Benjamin, Laborde-Casterot Hervé, Bérezné Alice, Dunogué Bertrand, Cohen Pascal, Puéchal Xavier, Mouthon Luc, Bensefa-Colas Lynda, Guillevin Loic
Department of Internal Medicine, National Referral Centre for Rare Autoimmune and Systemic Diseases, Cochin Hospital, Assistance Publique-Hôpitaux de Paris (AP-HP), Université Paris Descartes, France.
Department of Occupational and Environmental Diseases, Cochin Hospital, AP-HP, Université Paris Descartes, France.
Clin Exp Rheumatol. 2017 Mar-Apr;35 Suppl 103(1):40-46. Epub 2016 Dec 20.
Improved therapeutic strategies for ANCA-associated vasculitis (AAV) have transformed acute and life-threatening diseases into chronic ones responsible for marked morbidity that could impact employment, work disability and quality of life (QoL). We aimed to analyse work, handicaps and QoL of AAV patients and identify their determinants.
Patients with AAV were included in a cross-sectional study assessing employment, work disability and QoL. Specific and non-specific questionnaires, including SF-36, were sent to patients, and clinical-biological data that could affect QoL and their determinants were analysed.
Questionnaires were completed by 189 patients. Among 94 working-age (<60 years) patients, 57% had jobs, consistent with their qualifications for 81%, 77% were stably employed; 23% of workers felt that their disease qualitatively limited the nature of their work, while 43% felt it limited the quantity of work they could do; 50% thought their disease had hindered their careers and 43% that it had led to a salary reduction. These results were comparable for the different vasculitides. QoL was significantly impaired for AAV patients compared to the general population (p<0.0001). Physical health determinants for our population were diagnosis of eosinophilic granulomatosis with polyangiitis (EGPA), long disease duration and its neurological involvement, whereas mental health determinants tended to be ear, nose and throat and cardiovascular involvement, and unemployment.
Our findings showed that AAV patients' QoL was impaired compared to the general population, mainly for patients with EGPA and long-standing disease. In contrast, normal employment seemed to be preserved for the majority of the patients.
抗中性粒细胞胞浆抗体相关性血管炎（AAV）治疗策略的改进已将急性和危及生命的疾病转变为导致明显发病的慢性疾病，这可能会影响就业、工作能力丧失和生活质量（QoL）。我们旨在分析AAV患者的工作、残疾情况和生活质量，并确定其决定因素。
AAV患者纳入一项横断面研究，评估就业、工作能力丧失和生活质量。向患者发送包括SF-36在内的特定和非特定问卷，并分析可能影响生活质量及其决定因素的临床生物学数据。
189例患者完成了问卷。在94例工作年龄（<60岁）的患者中，57%有工作，与他们81%的资质相符，77%稳定就业；23%的工人认为他们的疾病在性质上限制了他们的工作，而43%的人认为这限制了他们能做的工作量；50%的人认为他们的疾病阻碍了他们的职业发展，43%的人认为这导致了工资减少。不同血管炎的这些结果具有可比性。与一般人群相比，AAV患者的生活质量显著受损（p<0.0001）。我们人群的身体健康决定因素是嗜酸性肉芽肿性多血管炎（EGPA）的诊断、疾病持续时间长及其神经受累，而心理健康决定因素往往是耳鼻喉和心血管受累以及失业。
我们的研究结果表明，与一般人群相比，AAV患者的生活质量受损，主要是EGPA患者和病程较长的患者。相比之下，大多数患者的正常就业似乎得以保留。
