早期银屑病关节炎中疾病表现对健康相关生活质量的影响。
Influence of Disease Manifestations on Health-related Quality of Life in Early Psoriatic Arthritis.
机构信息
From the Dutch south-west Early Psoriatic Arthritis cohort (DEPAR): Department of Rheumatology, Erasmus University Medical Center, and Maasstad Hospital, and Sint Franciscus Gasthuis, Rotterdam; Albert Schweitzer Hospital, Dordrecht; Vlietland Hospital, Schiedam; Amphia Hospital, Breda; Rivas Hospital, Gorinchem; Reumazorg Zuid West Nederland, Roosendaal, the Netherlands.
K. Wervers, PhD Student, Department of Rheumatology, Erasmus University Medical Center; J.J. Luime, PhD, Department of Rheumatology, Erasmus University Medical Center; I. Tchetverikov, MD, PhD, Department of Rheumatology, Albert Schweitzer Hospital; M.R. Kok, MD, PhD, Department of Rheumatology, Maasstad Hospital; A.H. Gerards, MD, Department of Rheumatology, Vlietland Hospital; C.W. Appels, MD, Department of Rheumatology, Amphia Hospital; W.L. van der Graaff, MD, PhD, Department of Rheumatology, Rivas Hospital; J.H. van Groenendael, MD, Reumazorg Zuid West Nederland; L.A. Korswagen, MD, Department of Rheumatology, Sint Franciscus Gasthuis; J.J. Veris-van Dieren, MD, Reumazorg Zuid West Nederland; J.M. Hazes, MD, PhD, Department of Rheumatology, Erasmus University Medical Center; M. Vis, MD, PhD, Department of Rheumatology, Erasmus University Medical Center.
出版信息
J Rheumatol. 2018 Nov;45(11):1526-1531. doi: 10.3899/jrheum.171406. Epub 2018 Jul 1.
OBJECTIVE
Psoriatic arthritis (PsA) is a multifaceted disease. Affecting joints, skin, entheses, and dactylitis, its effect on health-related quality of life (HRQOL) could be substantial. We aim to assess HRQOL in patients newly diagnosed with PsA and analyze its associations with disease manifestations.
METHODS
Data collected at time of diagnosis from patients with PsA included in the Dutch south-west Early Psoriatic Arthritis cohort (DEPAR) study were used. HRQOL was assessed using 8 domains of the Medical Outcomes Study Short Form-36 (SF-36) questionnaire. Patients were classified based on primary manifestation in arthritis subtypes (i.e., mono-, oligo-, or polyarthritis) and other subtypes (i.e., enthesitis, dactylitis, and axial disease). In all patients, presence of arthritis, enthesitis, dactylitis, psoriasis, and chronic inflammatory back pain was determined. Multivariable linear regression was used to determine associations of PsA manifestations with HRQOL.
RESULTS
Of 405 patients, primary manifestation was peripheral arthritis in 320 (78 monoarthritis, 151 oligoarthritis, and 91 polyarthritis), enthesitis in 37, axial disease in 9, and dactylitis in 39. Mean scores of SF-36 domains were lower than the Dutch reference population and similar across arthritis subtypes. A higher number of enthesitis locations and tender joints, and presence of chronic back pain, were independently associated with worse SF-36 scores. Psoriasis and dactylitis were not associated with worse scores.
CONCLUSION
HRQOL was diminished in PsA at time of diagnosis compared to the Dutch reference population, and tender joints, enthesitis at clinical examination, and back pain as indicators of pain affected HRQOL.
目的
银屑病关节炎（PsA）是一种多方面的疾病。它影响关节、皮肤、附着点和指（趾）炎，对健康相关生活质量（HRQOL）的影响可能很大。我们旨在评估新诊断为 PsA 的患者的 HRQOL，并分析其与疾病表现的关系。
方法
使用荷兰西南部早期银屑病关节炎队列（DEPAR）研究中纳入的新诊断为 PsA 的患者的数据。使用医疗结局研究短表 36 项（SF-36）问卷的 8 个领域评估 HRQOL。根据关节炎亚型（即单关节炎、寡关节炎或多关节炎）和其他亚型（即附着点炎、指（趾）炎和轴性疾病）对患者进行分类。在所有患者中，确定关节炎、附着点炎、指（趾）炎、银屑病和慢性炎症性背痛的存在情况。采用多变量线性回归分析 PsA 表现与 HRQOL 的关系。
结果
在 405 例患者中，主要表现为外周关节炎 320 例（78 例单关节炎、151 例寡关节炎和 91 例多关节炎）、附着点炎 37 例、轴性疾病 9 例和指（趾）炎 39 例。SF-36 各领域的平均得分低于荷兰参考人群，且在关节炎亚型之间相似。附着点炎部位和压痛关节数量较多，以及存在慢性背痛，与 SF-36 评分较差独立相关。银屑病和指（趾）炎与评分较差无关。
结论
与荷兰参考人群相比，PsA 在诊断时的 HRQOL 降低，且压痛关节、临床检查时的附着点炎以及背痛作为疼痛的指标，均影响 HRQOL。
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