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在初级保健人群中,与炎症性关节炎相关的症状很常见:来自关节症状调查的结果。

Symptoms associated with inflammatory arthritis are common in the primary care population: results from the joint symptoms survey.

机构信息

Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, UK.

Haywood Academic Rheumatology Centre, Midlands Partnership Foundation Trust, Stoke-on-Trent, UK.

出版信息

Rheumatology (Oxford). 2019 Nov 1;58(11):2009-2014. doi: 10.1093/rheumatology/kez184.

Abstract

OBJECTIVES

To describe the prevalence of self-reported inflammatory joint symptoms, such as joint pain, stiffness and swelling, in UK primary care patients consulting for both musculoskeletal (MSK) and non-musculoskeletal (non-MSK) complaints.

METHODS

A joint symptoms questionnaire survey was sent to 10 161 individuals, of whom 5050 had consulted for MSK problems. These were matched by age, gender and general practice to non-MSK consulters. Participants provided data on relevant symptoms such as joint pain, stiffness and swelling. The prevalence of these symptoms, their severity and impact were compared between MSK and non-MSK consulters.

RESULTS

A total of 4549 adults responded to the survey (adjusted response 45.8%) of whom 52.3% consulted for a MSK problem. The mean (s.d.) age was 61.6 (14.8) years and 58.9% were female. Persistent (on at least half of the days in the last month) inflammatory symptoms were common even in non-MSK consulters, with 42% reporting joint pain, 36% reporting joint stiffness and 18% reporting joint swelling. This is in comparison with 62% reporting joint pain, 50% stiffness and 24% swelling among MSK consulters.

CONCLUSIONS

Although symptoms such as persistent joint pain, swelling and stiffness are predictive of inflammatory arthritis, large numbers of people consulting primary care for non-MSK reasons report these symptoms when asked by questionnaire. This compounds the challenges of diagnosing inflammatory arthritis in a non-specialist setting where new approaches are needed to ensure accurate, early diagnosis, facilitating a treat-to-target approach.

摘要

目的

描述在英国初级保健患者中,报告有炎性关节症状(如关节疼痛、僵硬和肿胀)的患者比例,这些患者同时存在肌肉骨骼(MSK)和非肌肉骨骼(非 MSK)问题。

方法

对 10161 名患者进行了关节症状调查问卷调查,其中 5050 名患者因 MSK 问题就诊。这些患者按照年龄、性别和全科医生与非 MSK 就诊者相匹配。参与者提供了与关节疼痛、僵硬和肿胀等相关症状的数据。比较了 MSK 和非 MSK 就诊者之间这些症状的患病率、严重程度和影响。

结果

共有 4549 名成年人对调查做出了回应(调整后的回应率为 45.8%),其中 52.3%因 MSK 问题就诊。平均(标准差)年龄为 61.6(14.8)岁,58.9%为女性。即使在非 MSK 就诊者中,持续性(至少在过去一个月的一半以上天数存在)炎性症状也很常见,42%报告关节疼痛,36%报告关节僵硬,18%报告关节肿胀。相比之下,62%的 MSK 就诊者报告关节疼痛,50%的就诊者报告关节僵硬,24%的就诊者报告关节肿胀。

结论

尽管持续性关节疼痛、肿胀和僵硬等症状是炎症性关节炎的预测因素,但大量因非 MSK 原因就诊初级保健的患者在被问到问卷时会报告这些症状。这增加了在非专科环境中诊断炎症性关节炎的挑战,需要新的方法来确保准确、早期的诊断,从而实现治疗目标。

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