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类风湿关节炎发病率降低——一项基于全国人群队列研究的结果

Rheumatoid arthritis is getting less frequent-results of a nationwide population-based cohort study.

作者信息

Abhishek Abhishek, Doherty Michael, Kuo Chang-Fu, Mallen Christian D, Zhang Weiya, Grainge Matthew J

机构信息

Academic Rheumatology, School of Medicine, Clinical Sciences Building, City Hospital Nottingham, Nottingham.

Primary Care and Health Sciences, Keele University, Keele.

出版信息

Rheumatology (Oxford). 2017 May 1;56(5):736-744. doi: 10.1093/rheumatology/kew468.

Abstract

OBJECTIVES

The objectives of this study were to examine changes in the incidence and prevalence of RA between 1990 and 2014 and to explore if there is any geographic variation in the incidence and prevalence of RA in the UK.

METHODS

This was a primary care-based prospective cohort study. People contributing acceptable data to Clinical Practice Research Datalink between 1 January 1990 and 31 December 2014 were included. Read codes were used to identify RA cases ⩾18 years of age. The prevalence and incidence rates for each year were standardized to the 2014 population and the regional incidence and prevalence of RA for the year 2014 were standardized to the overall population.

RESULTS

The incidence and prevalence of RA was 3.81/10 000 person-years and 0.67%, respectively, in 2014. The annual incidence of RA decreased by 1.6% (95% CI 0.8, 2.5) between 1990 and 2014, with significant joinpoints at 1994 and 2002. The prevalence of RA increased by 3.7%/year (95% CI 3.2, 4.1) from 1990 to 2005 and decreased by 1.1%/year (95% CI 2.0, 0.2) between 2005 and 2014. There were significant differences in the occurrence of RA throughout different regions of the UK, with the highest incidence in East Midlands, Yorkshire and Humber and the highest prevalence in North East, Yorkshire and Humber.

CONCLUSION

The incidence of RA is decreasing, with a reduction in prevalence in recent years. There is significant geographic variation in the occurrence of RA in the UK. Further research is required to identify the reasons underlying this phenomenon so that public health interventions can be designed to further reduce the incidence of RA.

摘要

目的

本研究的目的是调查1990年至2014年间类风湿关节炎(RA)发病率和患病率的变化情况,并探究英国RA发病率和患病率是否存在地理差异。

方法

这是一项基于初级保健的前瞻性队列研究。纳入了在1990年1月1日至2014年12月31日期间向临床实践研究数据链提供可接受数据的人群。使用读取代码识别年龄≥18岁的RA病例。每年的患病率和发病率根据2014年的人口进行标准化,2014年RA的地区发病率和患病率根据总体人口进行标准化。

结果

2014年RA的发病率和患病率分别为3.81/10000人年和0.67%。1990年至2014年间,RA的年发病率下降了1.6%(95%置信区间0.8,2.5),在1994年和2002年有显著的连接点。1990年至2005年,RA的患病率以每年3.7%(95%置信区间3.2,4.1)的速度上升,2005年至2014年间以每年1.1%(95%置信区间2.0,0.2)的速度下降。英国不同地区的RA发病情况存在显著差异,东米德兰兹、约克郡和亨伯地区的发病率最高,东北、约克郡和亨伯地区的患病率最高。

结论

RA的发病率在下降,近年来患病率也有所降低。英国RA的发病情况存在显著的地理差异。需要进一步研究以确定这一现象背后的原因,以便设计公共卫生干预措施来进一步降低RA的发病率。

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