Roy Nelson, Tanner Kristine M, Merrill Ray M, Wright Charisse, Pierce Jenny L, Miller Karla L
1 Department of Communication Sciences and Disorders, The University of Utah, Salt Lake City, Utah, USA.
2 The Department of Communication Disorders, Brigham Young University, Provo, Utah, USA.
Ann Otol Rhinol Laryngol. 2018 Sep;127(9):577-587. doi: 10.1177/0003489418780136. Epub 2018 Jun 17.
This investigation examined the prevalence, symptoms, risk factors, and quality-of-life burden of swallowing disorders in rheumatoid arthritis (RA), a chronic, progressive autoimmune inflammatory disease.
One hundred individuals with RA (84 women, 16 men; mean age = 61.1 years, SD = 13.1) were interviewed regarding the presence, nature, and impact of swallowing symptoms and disorders. Associations between swallowing disorders, medical factors, RA disease severity, and quality of life were examined.
Forty-one percent of participants reported a current swallowing disorder that began gradually and was longstanding (most experiencing symptoms on a daily basis for at least 4 years). Symptoms compatible with solid food dysphagia contributed disproportionately to reporting a current swallowing disorder. Risk factors for dysphagia included a self-reported voice disorder, thyroid problems, esophageal reflux, and being physically inactive. Swallowing disorders increased with self-reported RA disease severity and contributed to a significantly greater burden on overall quality of life.
Chronic, longstanding swallowing disorders are common in individuals with RA and appear to increase with disease severity. Those individuals with dysphagia reported greater reductions in quality of life as compared to those without, highlighting the need for improved awareness, exploration, and management of swallowing disorders in this population.
本研究调查了类风湿关节炎（RA）这一慢性进行性自身免疫性炎症疾病中吞咽障碍的患病率、症状、危险因素及生活质量负担。
对100名类风湿关节炎患者（84名女性，16名男性；平均年龄 = 61.1岁，标准差 = 13.1）进行访谈，询问吞咽症状和障碍的存在情况、性质及影响。研究吞咽障碍、医学因素、类风湿关节炎疾病严重程度和生活质量之间的关联。
41%的参与者报告目前存在吞咽障碍，该障碍起病缓慢且持续时间长（大多数人每天都有症状，至少持续4年）。与固体食物吞咽困难相符的症状在报告目前吞咽障碍方面占比过高。吞咽困难的危险因素包括自我报告的嗓音障碍、甲状腺问题、食管反流和身体不活动。吞咽障碍随着自我报告的类风湿关节炎疾病严重程度增加而增多，并对总体生活质量造成显著更大的负担。
慢性、长期的吞咽障碍在类风湿关节炎患者中很常见，且似乎随疾病严重程度增加而增多。与无吞咽困难的患者相比，有吞咽困难的患者报告生活质量下降幅度更大，这凸显了提高对该人群吞咽障碍的认识、进行筛查和管理的必要性。
