系统性硬化症与其他风湿性疾病的健康相关生活质量比较：一项横断面研究。
Health-related quality of life in systemic sclerosis compared with other rheumatic diseases: a cross-sectional study.
机构信息
Division of Rheumatology, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, 03080, Republic of Korea.
Division of Immunology/Rheumatology, Stanford University, Palo Alto, CA, USA.
出版信息
Arthritis Res Ther. 2019 Feb 15;21(1):61. doi: 10.1186/s13075-019-1842-x.
BACKGROUND
Systemic sclerosis (SSc) is a rare autoimmune disease characterized by fibrosis of the skin and the involvement of multiple internal organs. Previous studies reported poorer health-related quality of life (HRQoL) in patients with SSc compared with the general population. However, very little is known about how HRQoL in SSc patients compares with that in patients with other systemic autoimmune diseases, such as rheumatoid arthritis (RA), systemic lupus erythematosus (SLE), and Sjogren's syndrome (SjS). Thus, the main aim of this study was to compare HRQoL in SSc patients, patients with other rheumatic diseases, and the general population.
METHODS
In this cross-sectional study, patients from the rheumatology clinics of Seoul National University Hospital with SSc, RA, SLE, and SjS were enrolled via a random sampling technique. HRQoL was captured by the Short Form (36) health survey (SF-36), the Short Form Six-Dimensional health index (SF-6D), and the EuroQol Five-Dimensional descriptive system (EQ-5D). Demographic characteristics and standardized disease activity for each disease were also obtained. Previously reported data from 600 healthy Koreans were used for the healthy controls. An ANCOVA test was used to compare the SF-36, SF-6D, and EQ-5D values between study subjects with adjustments for age, sex, disease duration, comorbidities, and disease activity status.
RESULTS
One hundred twenty patients were included in each of the SSc, RA, SLE, and SjS cohorts. Patients with rheumatic diseases had significantly lower SF-36, SF-6D, and EQ-5D scores than healthy controls (all P < 0.001). After statistical adjustments, SSc patients reported significantly lower mental component summary (MCS) scores than patients with RA (P < 0.001) or SLE (P = 0.001). Specifically, the mental health and general health domains were significantly lower in SSc patients than reported in RA or SLE patients (P < 0.001 and P = 0.001, respectively, in both domains). In SSc patients, higher modified Rodnan skin scores (mRSS) correlated with lower MCS scores.
CONCLUSIONS
SSc patients report poorer HRQoL than patients with RA or SLE. The extent of skin involvement is associated with poorer HRQoL in SSc patients.
TRIAL REGISTRATION
NCT03257878 . Registered 22 August 2017.
背景
系统性硬化症（SSc）是一种罕见的自身免疫性疾病，其特征为皮肤纤维化和多个内部器官受累。既往研究报道 SSc 患者的健康相关生活质量（HRQoL）较普通人群差。然而，对于 SSc 患者的 HRQoL 与其他系统性自身免疫性疾病（如类风湿关节炎（RA）、系统性红斑狼疮（SLE）和干燥综合征（SjS））患者的 HRQoL 相比如何，我们知之甚少。因此，本研究的主要目的是比较 SSc 患者、其他风湿病患者和普通人群的 HRQoL。
方法
在这项横断面研究中，通过随机抽样技术从首尔国立大学医院的风湿病诊所招募了 SSc、RA、SLE 和 SjS 患者。通过简明健康调查问卷（SF-36）、六维度健康指数简表（SF-6D）和欧洲五维健康量表（EQ-5D）评估 HRQoL。还获得了每个疾病的人口统计学特征和标准化疾病活动度。使用之前从 600 名健康韩国人获得的数据作为健康对照组。使用协方差分析（ANCOVA）检验，在调整年龄、性别、疾病持续时间、合并症和疾病活动状态后，比较研究对象的 SF-36、SF-6D 和 EQ-5D 值。
结果
每个 SSc、RA、SLE 和 SjS 队列均纳入 120 例患者。与健康对照组相比，风湿病患者的 SF-36、SF-6D 和 EQ-5D 评分明显较低（均 P<0.001）。经统计学调整后，SSc 患者的精神健康成分量表（MCS）评分明显低于 RA 患者（P<0.001）或 SLE 患者（P=0.001）。具体而言，SSc 患者的心理健康和一般健康领域的评分明显低于 RA 或 SLE 患者（均 P<0.001 和 P=0.001）。在 SSc 患者中，较高的改良 Rodnan 皮肤评分（mRSS）与较低的 MCS 评分相关。
结论
SSc 患者报告的 HRQoL 较 RA 或 SLE 患者差。皮肤受累程度与 SSc 患者的 HRQoL 较差相关。
试验注册
NCT03257878。注册日期：2017 年 8 月 22 日。
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